| NPI | 1053876979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A FRIEND Administrator 727-849-1309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2019-02-05 |