| NPI | 1124016175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI L KNEZ Administrator 863-299-5667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2008-04-20 |