| NPI | 1316248586 |
|---|---|
| Doing Business As | BODYLOGICMD OF JACKSONVILLE |
| Entity Type | Organization |
| Authorized Contact | JO ANN HOLOKA Director 877-341-8076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME108088) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-11-04 |