NPI | 1710900824 |
---|---|
Other Name | H.M. DUPERAULT JR. O.D. P.A. |
Entity Type | Organization |
Authorized Contact | HERMAN M DUPERAULT President 904-246-0404 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: FL OPC 672) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2008-06-20 |