| NPI | 1467712331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE E. VALLONE Owner 239-851-8468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: FL OPC 3193) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2012-05-24 |