| NPI | 1780100529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN MUELLER President, Director 386-231-3905 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2025-10-27 |