| NPI | 1841695533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN THOMAS Billing Manager 904-260-4461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME36669) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |