| NPI | 1972133163 |
|---|---|
| Former Legal Business Name | ULTRA MEDICAL LLC |
| Entity Type | Organization |
| Authorized Contact | ALFREDO INFANTE VP Operations 754-210-2460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |