Organization
CHAS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA JEAN PETITO (PRESIDENT)
(855) 242-6608
Entity
Organization
Contact information
Practice address
2580-3 COUNTY ROAD 220, MIDDLEBURG, FL 32068-6532
(855) 242-6608
(855) 242-6609
Mailing address
2580-3 COUNTY RD 220, MIDDLEBURG, FL 32068-6532
(855) 242-6608
(855) 242-6609
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/12/2013
Last updated
01/16/2015
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