| NPI | 1184378473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BUNNELL COO 239-470-4048 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 133N00000X Nutritionist |
| 171400000X | |
| 224Y00000X Clinical Exercise Physiologist | |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2022-02-07 |