| NPI | 1063825412 |
|---|---|
| Former Legal Business Name | PROGRESSIVE ATHLETIC DEVELOPMENT |
| Entity Type | Organization |
| Authorized Contact | DEDRICK LANARD AGEE Owner 205-249-9793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 583) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |