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1073076337
SME IDAHO P.C.
COLUMBIA, MO
NPI
1073076337
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Entity Type
Organization
Authorized Contact
OLUBUSOLA BRIMMO
Owner
678-977-5507
Organization Subpart ?
No
Primary Taxonomy
208D00000X General Practice
Enumeration Date
2019-04-12
Last Update Date
2019-04-12
Business Address
SME IDAHO P.C.
5728 PERGOLA DR APT 207
COLUMBIA, MO 65201-2897
Phone number: 678-977-5507
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Mailing Address
SME IDAHO P.C.
4321 COLLINGTON RD
BOWIE, MD 20716-2259
Phone number: 678-977-5507
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