| NPI | 1750527644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LUTHER LENTZ Director For Board 850-837-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME82437) |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2008-12-23 |