| NPI | 1598751216 |
|---|---|
| Former Legal Business Name | OSTEOPATHIC HERITAGE, CORP. |
| Entity Type | Organization |
| Authorized Contact | JEFFREY S. GROVE Physician/Owner 352-666-6950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS6098) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2017-12-12 |