| NPI | 1609312610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA LEIGH JOHNSON Physician 239-595-9939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME124467) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |