NPI | 1184643223 |
---|---|
Doing Business As | CRYSTAL FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | DAWN GOODPASTER President 352-794-5086 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
Enumeration Date | 2006-07-19 |
Last Update Date | 2020-08-22 |