| NPI | 1902893795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY JOAN LEVIN President 386-788-1881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2009-07-24 |