| NPI | 1487823274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ROBERT JOHNSON Owner/President 863-508-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME36699) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2008-02-26 |