Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI # | 1518782648 |
| LBN Legal business name | KIDZCARE PEDIATRICS, PLLC |
| Authorized official | MELISSA STOKES - (BILLING SUPERVISOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/22/2024 |
| Last updated | 11/22/2024 - More than a year ago |
| Identifiers | n/a |
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