| NPI | 1265727861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANNING C. BOLICK Mgr 407-629-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME45785) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7882) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2011-06-13 |