| NPI | 1144459819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM WEISS President/Owner 904-642-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL 46322) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |