| NPI | 1629467717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANNING HAROLD HANLINE Physician 850-438-1878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME32755) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |