| NPI | 1548429590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERROLD RANDALL ECKLINDS President 386-615-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL os7663) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-27 |