Organization
BRONZE OWL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANTOINETTE CECILE WILLIAMS RN (OWNER)
(805) 369-4935
Entity
Organization
Contact information
Practice address
1424 CAPE COD WAY, CONCORD, CA 94521
(805) 369-4935
Mailing address
3752 BRIAR LN, ORANGE PARK, FL 32065
(805) 369-4935
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
94375
CA
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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