| NPI | 1205265659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL DOUGLAS MILLER President 386-366-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME107699) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |