NPI | 1780955997 |
---|---|
Entity Type | Organization |
Authorized Contact | KIM BARTHOLOMEW POWERS Owner 727-541-0323 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS6697) |
Enumeration Date | 2012-01-19 |
Last Update Date | 2012-01-19 |