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Organization
PORTABLE PICCLINE INSERTION
Active
Organization
PORTABLE PICCLINE INSERTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWEN MARSHALL (CEO)
(817) 566-4899
Entity
Organization
Contact information
Practice address
2304 OAK LN STE 205, GRAND PRAIRIE, TX 75051-8816
(972) 201-4091
Mailing address
221 BUIE DR, FORT WORTH, TX 76140-2931
(817) 566-4899
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
11/24/2017
Last updated
11/24/2017
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