| NPI | 1205862802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY GULMER JOHNSON President 386-719-6576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: FL RN2797442) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-22 |