| NPI | 1568914935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIJO ST-LAURENT VP Of Operations 386-317-9067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL CH10487) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2019-04-25 |