| NPI | 1942635362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA SOWARDS Clinical Supervisor 877-358-8648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1800X Clinic/Center, Corporate Health |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2013-09-04 |