| NPI | 1285888180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J LECROY Owner, Physician 850-479-1805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2020-06-12 |