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Organization

MAMA NATURAL BIRTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL HOWLAND PUGH (PARTNER)
(312) 259-4587
Entity
Organization

Contact information

Practice address
86 OKEECHOBEE CIR, SANTA ROSA BEACH, FL 32459-8798
(312) 259-4587
Mailing address
86 OKEECHOBEE CIR, SANTA ROSA BEACH, FL 32459-8798
(312) 259-4587

Taxonomy

Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123456
N/A
Enumeration date
03/26/2021
Last updated
03/26/2021
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