NPI | 1619257961 |
---|---|
Entity Type | Organization |
Authorized Contact | KUCHAKULLA N REDDY Treasurer 352-732-9844 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
Enumeration Date | 2011-08-18 |
Last Update Date | 2016-05-05 |