| NPI | 1508824236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI GOFF Owner 407-312-4133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL PT 16192) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-08-22 |