| NPI | 1003624008 |
|---|---|
| Other Name | WELL WATERED PLACE LLC |
| Entity Type | Organization |
| Authorized Contact | JIMEKA LEVELLE FITZGERALD CEO 757-800-7301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2024-12-21 |
| Last Update Date | 2024-12-21 |