NPI | 1275706681 |
---|---|
Entity Type | Organization |
Authorized Contact | LORRIE ANN RICHARDSON-O'NEAL Co Owner 478-676-2040 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 036094504) |
Enumeration Date | 2008-04-07 |
Last Update Date | 2008-04-07 |