| Spirit Soaring Medical Pllc | |
|
2761 Johnson Hill Rd Swain NY 14884-9707 | |
| (607) 564-8011 | |
| Not Available |
| Full Name | Spirit Soaring Medical Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2761 Johnson Hill Rd, Swain, New York |
| Authorized Official Name and Position | Jacob Tallman (OWNER) |
| Authorized Official Contact | 6075648011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spirit Soaring Medical Pllc 2761 Johnson Hill Rd Swain NY 14884-9707 Ph: (607) 564-8011 | Spirit Soaring Medical Pllc 2761 Johnson Hill Rd Swain NY 14884-9707 Ph: (607) 564-8011 |
| NPI Number | 1639703192 |
|---|---|
| Provider Enumeration Date | 02/24/2020 |
| Last Update Date | 02/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639703192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |