| NPI | 1649504515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE S PETRYK President 239-482-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204R00000X Electrodiagnostic Medicine (Licence: FL OS7123) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL CH8431) |
| 208D00000X General Practice (Licence: FL OS7123) | |
| 293D00000X Physiological Laboratory | |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2012-06-14 |