| NPI | 1154533677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MARK GARNEY President 850-638-5512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2017-10-18 |