NPI | 1780074831 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID C BLUMER Sole Proprietor 352-372-1878 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 30193) |
Enumeration Date | 2015-01-28 |
Last Update Date | 2015-01-28 |