| NPI | 1629509344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINTHIANS DEQUINDRAE WASHINGTON Owner 706-615-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: GA 055473103) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |