NPI | 1225180805 |
---|---|
Entity Type | Organization |
Authorized Contact | JEROME CRAFT Owner President 561-626-9021 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ME0010445) |
Enumeration Date | 2007-01-17 |
Last Update Date | 2020-08-22 |