| NPI | 1679705776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MILTON TIEGEN President 561-624-9744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL 0000691) |
| Enumeration Date | 2009-08-23 |
| Last Update Date | 2009-08-23 |