| NPI | 1619293347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET VERGO ATTLESEY President 904-221-3394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0071470) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2010-05-28 |