| NPI | 1841236726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN CRUMLISH Secretary/Treasurer 850-476-9088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2010-06-16 |