| NPI | 1407261761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CAVANAUGH Billing Manager 386-283-5668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN9287320) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-06-25 |