NPI | 1134837057 |
---|---|
Other Name | ROOTED VIGOR, LLC |
Entity Type | Organization |
Authorized Contact | MARY IYESHIA GAMBLE Founder/CEO 813-397-8824 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2022-11-09 |
Last Update Date | 2022-11-09 |