| NPI | 1154990547 |
|---|---|
| Doing Business As | NORTH OKALOOSA CLINIC CORP |
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Sr Dir Prov Enrollment & Onboarding 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2022-03-18 |