NPI | 1811981178 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY S GROVE President 727-588-9572 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS6098) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH5247) |
Enumeration Date | 2005-09-01 |
Last Update Date | 2013-01-24 |