| 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 |