| NPI | 1558735522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MATTHEW EVERETT Principal 239-322-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2015-11-13 |