NPI | 1710398821 |
---|---|
Former Legal Business Name | LACEY STEWART, LLC |
Entity Type | Organization |
Authorized Contact | LACEY STEWART Owner 505-440-7169 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: NM 0187211) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2014-05-12 |
Last Update Date | 2022-10-17 |