| NPI | 1902832405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA A HARMS Administrator 904-332-6774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 14960580) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-08-22 |