| NPI | 1841673928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ALLYN RUTERBUSCH Owner 904-505-0628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 2083A0100X Preventive Medicine, Aerospace Medicine | |
| 2083B0002X Preventive Medicine, Obesity Medicine | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2019-08-19 |