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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice |
| NPI Number | 1992310593 |
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| LBN Legal business name | JUST THE RIGHT AGE | ||||
| Authorized official | DONALD HASTIE - (MANAGER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 09/10/2020 | ||||
| Last updated | 09/10/2020 - About 6 years ago | ||||
| Identifiers |
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