| NPI | 1942318308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CEDRIC B MASA Md 701-732-2710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2020-02-21 |