| NPI | 1639304702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY E PINKSTON President/Owner 850-473-1008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC7432) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |