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General NPI Number Information
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NPI Number | 1568934560
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Entity Type | Organization
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Legal Business Name | POINT WASHINGTON MEDICAL CLINIC INC
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 1321 N COUNTY HIGHWAY 395
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-5916
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Country | US
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Telephone | 850-213-1133
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Fax | 850-213-2533
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Provider Business Mailing Address
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Address Line | 1321 N COUNTY HIGHWAY 395
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-5916
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Country | US
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Telephone | 850-213-1133
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. HILLARY GLENN
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Credential | DNP, APRN
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Telephone | 850-213-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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