| NPI | 1326474271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC SCOTT CHASTAIN Owner 904-527-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL 604198) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |