| NPI | 1740781509 |
|---|---|
| Other Name | CCN CLOVIS |
| Entity Type | Organization |
| Authorized Contact | AARONJACK RUSSELL PERRY Chairman 559-281-9575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 374K00000X Religious Nonmedical Practitioner |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-06-16 |