| NPI | 1730439118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT T. REIGHTNOUR Therapist 850-774-4692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL MH9708) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |