| NPI | 1205828753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSTON L HESS President/Owner 386-405-8791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-05-29 |