| NPI | 1790060333 |
|---|---|
| Former Legal Business Name | ED MEDICAL THERAPY CENTER, INC. |
| Entity Type | Organization |
| Authorized Contact | JANIS GOMEZ President 813-407-1591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FM HCC9274) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2015-05-05 |