| NPI | 1114589645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN RAMON BURGOS Co Owner/Manager 910-483-8406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2019-07-04 |
| Last Update Date | 2019-07-04 |