| NPI | 1578928396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN B PARKHURST Director Of Operations 772-692-8082 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME74643) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2015-12-21 |