| NPI | 1043233380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOHNSON President 904-296-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory (Licence: FL HCC3853) |
| Additional Taxonomies | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: FL HCC3853) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2013-02-12 |