| NPI | 1164709952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN LYNN GLOER Practice Administrator 727-541-2675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2011-11-08 |