| NPI | 1417264201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTEL SPRING HARLOW Owner 251-343-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AL 1964) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |