| NPI | 1932720521 |
|---|---|
| Doing Business As | PACL NEW YORK |
| Entity Type | Organization |
| Authorized Contact | TYLER JUSTISS Controller 404-216-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |