| NPI | 1952857823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRICE WILLIAM BLATZ Owner 408-440-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A124037) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-09-06 |