| NPI | 1750628186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE LIVINGSTON Owner 386-274-5712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN9299567) |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2013-01-04 |