| NPI | 1972969756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA MORA Ancillary Manager, Physical Therapy 904-674-2023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME80485) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2021-07-13 |