Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI # | 1215751508 |
| LBN Legal business name | WILLIAMS MEDICAL GROUP PRACTICE, LLC |
| Authorized official | GRANT ASAY - (CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/13/2024 |
| Last updated | 11/13/2024 - More than a year ago |
| Identifiers | n/a |
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