| NPI | 1760724314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM B HENGHOLD Physician/Owner 850-474-4775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-03-27 |