| NPI | 1104907328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH L STORY Chairman Of Board Of Managers 850-469-2338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |