| NPI | 1902430531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY W KING Owner 385-292-8868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2021-03-02 |