| NPI | 1770747990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE ANNE STEVENSON Managing Partner 386-663-3003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS9438) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2008-07-16 |