| NPI | 1629693593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS ROBERT DAVIS Manager/ Owner 972-816-5969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |