| NPI | 1740640150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JAMES DI BLASI Physician 904-482-9673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 75206) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |