Organization
IMPACT MEDICAL LLC
Active
Organization
IMPACT MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IHUOMA OTTIH NP (APN-C/ OWNER)
(267) 474-1355
Entity
Organization
Contact information
Practice address
244 AMAN AVE, CLEMENTON, NJ 08021-2502
(267) 474-1355
Mailing address
244 AMAN AVE, CLEMENTON, NJ 08021-2502
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00349900
NJ
Other
Enumeration date
12/04/2011
Last updated
12/04/2011
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