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1790089977
RECONCILIATION & RESTORATION
GRIMESLAND, NC
NPI
1790089977
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Entity Type
Organization
Authorized Contact
TAMUR KISHON TAYLOR-ALEXANDER
CEO
252-402-9375
Organization Subpart ?
No
Primary Taxonomy
302F00000X Exclusive Provider Organization
Enumeration Date
2011-01-03
Last Update Date
2011-01-03
Business Address
RECONCILIATION & RESTORATION
518 RACHEL LN
GRIMESLAND, NC 27837-9246
Phone number: 252-402-9375
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Mailing Address
RECONCILIATION & RESTORATION
518 RACHEL LN
GRIMESLAND, NC 27837-9246
Phone number: 252-402-9375
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