| NPI | 1780128777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY TEACHOUT Vice President 239-466-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 12025) |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2022-11-07 |