| NPI | 1669651261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNETTE WILLIAMS Office Assistant 239-368-7270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME85508) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2007-10-31 |