Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1962656496 |
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| LBN Legal business name | COMPANY CARE CENTER | ||||
| Authorized official | CONNIE POULTON - (VICE PRESIDENT OF SUPPORT SERVICES) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 11/11/2008 | ||||
| Last updated | 11/11/2008 - About 18 years ago | ||||
| Identifiers |
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COMPANY CARE CENTER
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