NPI | 1114460227 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIDGETT ELAINE EDWARDS Provider 941-900-2701 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 171100000X Acupuncturist |
Enumeration Date | 2016-11-21 |
Last Update Date | 2017-05-30 |