| NPI | 1790278356 |
|---|---|
| Doing Business As | VANITY |
| Entity Type | Organization |
| Authorized Contact | JESIKA HARRELL Member 904-716-8955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: AK PADA1252) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK PADA1252) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-06-08 |