| NPI | 1184397713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSHA PETTIS Owner 352-431-1193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 374700000X Technician |
| Additional Taxonomies | 246R00000X Technician, Pathology |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-09-13 |