| NPI | 1457895757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN JEAN HATHAWAY Acupuncturist 321-723-3017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL AP1352) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: OR AC164809) |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |