| NPI | 1225046626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER H. BOWER Chief Medical Officer 386-323-7542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME 88745) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |