| NPI | 1083141840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS GRANT President/Managing Member 352-566-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |