| NPI | 1306557319 |
|---|---|
| Former Legal Business Name | IMPERIAL SYNERGY LLC |
| Entity Type | Organization |
| Authorized Contact | DERRIC THOMPSON Owner 323-772-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2022-12-09 |