| NPI | 1588348262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RIVARD Owner 727-300-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| Enumeration Date | 2023-06-13 |
| Last Update Date | 2023-06-14 |