| NPI | 1841682705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD DAVISON GARDNER Managing Member 239-940-2263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0056224) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-05 |