| NPI | 1326076977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GOODEN Owner 972-786-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-10-19 |