| NPI | 1053850784 |
|---|---|
| Other Name | OLIVE TREE COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | NDIDIAMAKA OKPAREKE President And Owner 706-509-1012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NM PH00004369) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |