| NPI | 1164435277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ROY CHEWNING Owner/President 386-256-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS8215) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2014-02-14 |