Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
261QP2300X |
| NPI # | 1477979672 |
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| LBN Legal business name | RMCCA CLINIC A, LLC | ||||
| Authorized official | AMANDA SALTER - (DIRECTOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 03/12/2014 | ||||
| Last updated | 03/20/2020 - About 6 years ago | ||||
| Identifiers |
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