| NPI | 1164242830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE HOLLOWAY Executive Director 904-202-5378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-10-16 |