Home » » 1215202288

1215202288 deactivated on Aug 26, 2019

NPI 1215202288 deactivated on Aug 26, 2019.

profile-icon Basic Information

Practice Location , ,
Practice Location Phone
Practice Location Fax
Gender
Specialty InNot specified
NPI ?1215202288
Entity Type
Enumeration Date ?
Last Update Date ?
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).