Bridgeance Corp

NPI 1083979876 - Clinical Medical Laboratory - 291U00000X

NPI Details
NPI 1083979876
Enumeration Date 07/09/2012
Last Updated 07/09/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name DANIEL DANIEL
Position CEO/PRES
Phone (812) 287-3946
Fax
Practice Location
801 S WEST ST
EXECUTIVE CENTER SUITE 123
OLNEY IL, 62450-1334, US
Phone (812) 287-3946
Fax
Business Location
801 S WEST ST
EXECUTIVE CENTER SUITE 123
OLNEY IL, 62450-1334, US
Phone
Fax
Toxanomy
Taxonomy Code 291U00000X
License State
License Number
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According to our database, Bridgeance Corp NPI is 1083979876, taxonomy code is 291U00000X Bridgeance Corp physically located at 801 S West St, Olney IL, 62450-1334. NPI Number 1033115704 has the healthcare provider type.

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1083979876 NPI number is provided on an as is basis without warranty of any kind. 1083979876 is maintained by the National Plan & Provider Enumeration System. The contents of Bridgeance Corp are for informational purposes only.