| NPI | 1598926263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDLER MOHAN Managing Member 386-466-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101243179) |
| 208D00000X General Practice (Licence: VA 0101243179) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2020-03-04 |