| NPI | 1790195691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDAWRD PATTON Director/Owner 239-262-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP488) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: FL MH2616) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-05-22 |