NPI | 1205567039 |
---|---|
Entity Type | Organization |
Authorized Contact | WILBURN TURNER DAVIS Manager 850-933-4342 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
261QM0850X Clinic/Center, Adult Mental Health | |
Enumeration Date | 2022-06-22 |
Last Update Date | 2022-06-22 |