| NPI | 1427194968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP GOODWIN President 386-437-4711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: FL ME78172) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2008-09-04 |