Organization
DELMAR GLEN PACK PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNE ZIMMERMAN (ENROLLMENT SPECIALIST)
(954) 366-2700
Entity
Organization
Contact information
Practice address
810 BRIARWOOD CT, ORANGE CITY, FL 32763-4319
(386) 956-1689
Mailing address
810 BRIARWOOD CT, ORANGE CITY, FL 32763-4319
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6914
FL
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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