| NPI | 1356969406 |
|---|---|
| Doing Business As | B BRIDGE BACK LLC |
| Entity Type | Organization |
| Authorized Contact | DIMITRY LIKTEREV Co Owner 844-877-2440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2024-11-18 |