| NPI | 1992409262 |
|---|---|
| Other Name | LUCEDALE FAMILY MEDICAL CLINIC, LLC |
| Entity Type | Organization |
| Authorized Contact | BRIDGOT PETERS Billing Director 251-445-7618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2024-05-10 |