| NPI | 1508179490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH S RYBACK President 239-303-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 1508179490) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL ME 92563) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2020-11-24 |