| NPI | 1962292409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BALLINGER Owner 731-571-0902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |