| NPI | 1457177222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN CORNELIUS SALLEY Owner 727-594-7386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2024-11-26 |