| NPI | 1871819532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A LAINE President 561-758-8810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL ME0076092) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2010-04-20 |