Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI # | 1285326819 |
| LBN Legal business name | BELLEVIEW INTEGRATED DTC-PC |
| Authorized official | TAMARA JOHNSON - (MEDICAL DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/23/2023 |
| Last updated | 05/23/2023 - About 3 years ago |
| Identifiers | n/a |
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