| NPI | 1710298666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY M MEREDITH Owner 772-878-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL CH0006729) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-10-06 |