| NPI | 1114104221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHRISTENSEN Medical Doctor 561-655-2225 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME92135) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-05-05 |