| NPI | 1740627165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA PULLEN Owner/Director 850-588-5689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL PA 9104277) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2013-05-24 |