Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI # | 1619632817 |
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| LBN Legal business name | FAST PACE MEDICAL CLINIC PLLC | ||||
| Authorized official | ROBERT BENSON - (COO) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 11/02/2021 | ||||
| Last updated | 11/02/2021 - About 5 years ago | ||||
| Identifiers |
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