NPI | 1972812865 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH W TRUSSELL President/Owner 813-685-4222 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: FL 6246) |
Enumeration Date | 2010-09-27 |
Last Update Date | 2010-09-27 |