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Organization

OPTIMUM HORIZON LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. OSAGYEFO A GREENE (OWNER)
(980) 721-7785
Entity
Organization

Contact information

Practice address
6412 MALLARD VIEW LN, CHARLOTTE, NC 28269-5121
(980) 721-7785
Mailing address
6412 MALLARD VIEW LN, CHARLOTTE, NC 28269-5121
(980) 721-7785

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
NC

Other

Enumeration date
02/10/2012
Last updated
02/10/2012
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