| NPI | 1912763517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB C MOENCH Owner 385-368-6377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2025-08-15 |