| NPI | 1194093278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE S PETRYK Managing Member 239-482-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: FL CH8431) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL OS7123) |
| 293D00000X Physiological Laboratory (Licence: FL CH8431) | |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2024-02-05 |