| NPI | 1760772032 |
|---|---|
| Doing Business As | ABC |
| Entity Type | Organization |
| Authorized Contact | RICHARD BUNT Medical Director 321-622-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: FL ME98371) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-05-19 |