| NPI | 1861696627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER CARROLL Owner 239-289-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL PT6108) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2007-08-14 |