| NPI | 1447290812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL MYRICK Owner 904-421-2119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-07-25 |