| NPI | 1962894063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA A KIMBLE Practice Owner 850-877-4744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 0063139) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-02-26 |