NPI | 1942848940 |
---|---|
Doing Business As | KERRY BANTA |
Entity Type | Organization |
Authorized Contact | KERRY DAVENPORT BANTA Owner 717-503-5909 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Enumeration Date | 2019-12-20 |
Last Update Date | 2019-12-20 |