| NPI | 1114498672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL THOMPSON Owner 817-680-9408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2018-12-10 |