| NPI | 1497184592 |
|---|---|
| Other Name | PROVIDENCE TILLMANS CORNER OCC MED |
| Entity Type | Organization |
| Authorized Contact | JAMES L. WALKER President 251-633-8880 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |