NPI | 1912205337 |
---|---|
Entity Type | Organization |
Authorized Contact | BLAKE ANTHONY WASINGER President 214-300-1177 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: KS 01-05352) |
Enumeration Date | 2011-03-09 |
Last Update Date | 2011-03-09 |