NPI | 1316599624 |
---|---|
Entity Type | Organization |
Authorized Contact | KACEY A MONTGOMERY Regional Medical Director 850-791-6895 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2019-07-16 |
Last Update Date | 2022-05-17 |