| NPI | 1275257305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE COLVIN President 850-784-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2024-07-09 |