Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
261QP2300X | |||
Health Service |
261QH0100X | |||
Urgent Care |
261QU0200X |
| NPI # | 1316636913 |
| LBN Legal business name | EHEALTH 360 |
| Authorized official | SHANNON FRY - (APRN/OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/01/2023 |
| Last updated | 05/01/2023 - About 3 years ago |
| Identifiers | n/a |
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