| NPI | 1962386177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA NICOLE WATTS Manager 386-313-0720 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS1200X Clinic/Center Sleep Disorder Diagnostic |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-01 |