| NPI | 1417144759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLYNNIS J. LYONS Owner/Physician 772-286-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS4419) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |