NPI | 1528200029 |
---|---|
Doing Business As | AVANTI WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | RANDI B BRAZER Director Of Operations 904-797-3115 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC7499) |
Additional Taxonomies | 208D00000X General Practice |
Enumeration Date | 2009-03-30 |
Last Update Date | 2011-08-18 |