| NPI | 1831333186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE BRADLEY HOUSTON President 904-388-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0055161) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2009-04-29 |