Organization
NEXT LEVEL FITNESS & BOXING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LENOLA LAVERNE COOKS (CHIEF BOOK KEEPER)
(803) 278-5563
Entity
Organization
Contact information
Practice address
738 E MARTINTOWN RD, NORTH AUGUSTA, SC 29841-4288
(803) 292-2480
Mailing address
1059 TODD AVE, NORTH AUGUSTA, SC 29841-4451
(803) 278-5563
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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