| NPI | 1134133416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY E LEACH Owner/President 239-566-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME42024) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2012-01-30 |