| NPI | 1619304573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL CHARLESTON Owner 561-278-9005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113665) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH8492) |
| Enumeration Date | 2013-10-08 |
| Last Update Date | 2013-10-08 |