| NPI | 1992155097 |
|---|---|
| Other Name | BRIDGEPORT FAMILY HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL TILLMAN CEO 681-342-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-06-20 |