| NPI | 1912206723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE T BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 208600000X Surgery | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-08-16 |