Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2018-07-05
- Last updated
- 2018-07-05
Licenses
- License FL
- MH9903
Location
- Practice location
- 516 S 10TH ST STE 119
- City
- FERNANDINA BEACH FL
- Postal code
- 320343511
- Phone
- 904-863-6746
Organization contact
- Name
- JULIE EBERWEIN
- Title
- Co-Founder
- Phone
- 9048636746
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
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