| NPI | 1104829316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRI J HARTLEY Office Administrator 352-357-8615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL notrequired) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL notrequired) |
| 213E00000X Podiatrist (Licence: FL notrequired) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2010-06-22 |