| NPI | 1922205251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINA L FEASTER President Md 904-794-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME79232) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-11-20 |