| NPI | 1164196861 |
|---|---|
| Doing Business As | FAMILY HEALTH SOURCE |
| Entity Type | Organization |
| Authorized Contact | LAURIE ASBURY CEO 386-749-9449 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2021-08-05 |