| NPI | 1457401283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN MARSHALL RINGSDORF Owner 251-867-5274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AL 1569) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2008-06-23 |