| NPI | 1710946470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES V. KLUCKA Owner 239-939-2246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: FL 0S 0006759) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2008-11-25 |