NPI | 1700129756 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIN L INGA Administrator 772-299-4623 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 1623692) |
Enumeration Date | 2013-03-28 |
Last Update Date | 2013-03-28 |