| NPI | 1396182317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC E MCCOLLAUM President 239-641-6871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME36001) |
| Additional Taxonomies | 111N00000X Chiropractor |
| 133V00000X Dietitian, Registered | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2025-08-13 |