| NPI | 1275846800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENTON D THRASHER Owner 386-882-8221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL me77922) |
| Enumeration Date | 2010-07-25 |
| Last Update Date | 2010-08-02 |