NPI | 1508999871 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD BLAKE SMITH Owner 662-234-1731 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 174400000X Specialist |
Enumeration Date | 2007-03-14 |
Last Update Date | 2022-07-21 |