| NPI | 1134832678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOELLEN RICH Owner Operator 850-316-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2022-12-29 |