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Organization
STUMP MED
Active
Organization
STUMP MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANILLE CRETHERS (PRESIDENT/OWNER)
(904) 502-8213
Entity
Organization
Contact information
Practice address
2876 LANTANA LAKES DR E, JACKSONVILLE, FL 32246-1807
(904) 502-8213
Mailing address
2876 LANTANA LAKES DR E, JACKSONVILLE, FL 32246-1807
(904) 502-8213
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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