| NPI | 1255019113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE WARD Director 386-845-4022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| 253Z00000X In Home Supportive Care | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2024-10-22 |