| NPI | 1598842221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN C COUCH Treasurer 352-746-0654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |