| NPI | 1215670898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES C PRESSWOOD CFO 386-615-4237 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2022-04-20 |