| NPI | 1740528942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYONTA LAQUARY TAFT Owner 252-814-6997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: NC 23481314) |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2013-01-22 |