| NPI | 1639354244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA J HEINRICH Office Manager 877-257-9619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101036334) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2009-10-20 |