| NPI | 1508377383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHUNDOBIE TOMEKA COLEMAN Owner 601-201-6807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS 335215) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2018-06-16 |