| NPI | 1538604509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA BOSWELL Billing Manager 251-943-9954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME80025) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 10642) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |