| NPI | 1871901934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE M CHALKER Owner 386-225-4553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL OPC 3585) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-01 |