NPI | 1770905937 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSE MARIE ALBATROSOV Owner 386-562-8213 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL BT-72927) |
Enumeration Date | 2014-01-07 |
Last Update Date | 2014-01-07 |