| NPI | 1154591279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN GRENZENBACH A RN P Business Owner 772-567-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 3396072) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2012-02-01 |