| NPI | 1174578579 |
|---|---|
| Doing Business As | MEMORY DISORDER CLINIC |
| Entity Type | Organization |
| Authorized Contact | RANDY BUTLER CFO 850-494-4125 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2009-03-06 |