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1093423535
CC1 MEDICAL HOLDING LLC
FT WORTH, TX
NPI
1093423535
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Entity Type
Organization
Authorized Contact
GINA SULLIVAN
Practice Administrators
903-259-0550
Organization Subpart ?
No
Primary Taxonomy
204R00000X Electrodiagnostic Medicine
Enumeration Date
2022-11-14
Last Update Date
2022-11-14
Business Address
CC1 MEDICAL HOLDING LLC
111 BOLAND ST STE 211
FT WORTH, TX 76107-1265
Phone number: 817-529-8488
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Mailing Address
CC1 MEDICAL HOLDING LLC
111 BOLAND ST STE 211
FT WORTH, TX 76107-1265
Phone number: 817-529-8488
Copy
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