| NPI | 1255859641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROYCE MCGOWAN President 904-350-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2024-12-13 |