| NPI | 1972894244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY R. MEADOWS Owner 800-507-8874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |