| NPI | 1467645929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A PHILLIP CAMPBELL Owner 407-328-0825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00045100) |
| Enumeration Date | 2007-08-19 |
| Last Update Date | 2007-08-19 |