| NPI | 1649715608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RICHARDS Director Of Account Management 561-413-9860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: OK 12457565) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |