Organization
GOOD SAMARITAN CLINIC OF WEST VOLUSIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLE WADSWORTH (MEDICAL DIRECTOR)
13867386990
Entity
Organization
Contact information
Practice address
136 E PLYMOUTH AVE, DELAND, FL 32724-2871
(138) 673-8699
Mailing address
136 E PLYMOUTH AVE, DELAND, FL 32724-2871
(138) 673-8699
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
ARNP 694272
FL
Other
Enumeration date
08/01/2016
Last updated
08/01/2016
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