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1982457081
IMPACT PRACTITIONER SERVICES, LLC
FORT PIERCE, FL
NPI
1982457081
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Entity Type
Organization
Authorized Contact
KELLI KRAAZ
Sole Propietor
772-528-5991
Organization Subpart ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
Enumeration Date
2024-04-09
Last Update Date
2024-04-09
Business Address
IMPACT PRACTITIONER SERVICES, LLC
3307 N INDIAN RIVER DR
FORT PIERCE, FL 34946-8418
Phone number: 772-528-5991
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Mailing Address
IMPACT PRACTITIONER SERVICES, LLC
3307 N INDIAN RIVER DR
FORT PIERCE, FL 34946-8418
Phone number: 772-528-5991
Copy
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