| NPI | 1144458647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOSEPH CLANCY Physician Assistant 850-398-8668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: FL ME93880) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2010-08-27 |