| NPI | 1609584614 |
|---|---|
| Former Legal Business Name | SAGE CONDOMINIUM SERVICES |
| Entity Type | Organization |
| Authorized Contact | CARLA YVETTE TRACY Owner 304-638-0295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2022-11-08 |