| NPI | 1306370283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY C LU Credentialing Manager 904-221-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1200X Clinic/Center Sleep Disorder Diagnostic |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2019-02-26 |