| NPI | 1770071011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SNOW Owner 574-229-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL CH11998) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |