| NPI | 1538504063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER PAULSON Program Director 850-883-8192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2013-05-10 |