NPI | 1801604707 |
---|---|
Entity Type | Organization |
Authorized Contact | LASANDRA LEE Owner 561-598-9609 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2024-12-23 |
Last Update Date | 2024-12-23 |