| NPI | 1962853614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY SIMPSON Owner, Emily Simpson. Lmt 512-573-3960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: OR 18634) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |