| NPI | 1235454000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE KINCART President 904-645-8778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 0057407) |
| Additional Taxonomies | 132700000X Dietary Manager |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-04-05 |