Organization
CRAWFORD
Active
Organization
CRAWFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVON POORE (OWNER)
(937) 272-0613
Entity
Organization
Contact information
Practice address
3215 WINDSHIRE LN UNIT 205, CHARLOTTE, NC 28273-4190
(937) 272-0613
Mailing address
3215 WINDSHIRE LN UNIT 205, CHARLOTTE, NC 28273-4190
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
RT276028
OH
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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