| NPI | 1811357536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN K CHILDRESS Practice Manager 941-357-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS9810) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2020-10-06 |