NPI | 1457801417 |
---|---|
Entity Type | Organization |
Authorized Contact | BILLY LEE WILSON Owner 530-945-2192 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA MFC43963) |
Enumeration Date | 2016-10-13 |
Last Update Date | 2016-10-13 |