| NPI | 1871781146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA D HENSLEY CEO 239-390-9933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME79598) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |