NPI | 1134995830 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN C AUSTIN Medical Director 863-777-2736 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 170300000X Genetic Counselor, MS |
208D00000X General Practice | |
Enumeration Date | 2023-12-04 |
Last Update Date | 2024-03-06 |