| NPI | 1215737721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE MCDONNELL Owner 757-984-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-05-30 |