Organization
SUN RISE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALPHA TONGOR (SHAREHOLDER)
(614) 772-3106
Entity
Organization
Contact information
Practice address
3301 E MAIN ST STE 2, COLUMBUS, OH 43213-2740
(614) 772-3106
Mailing address
3301 E MAIN ST STE 2, COLUMBUS, OH 43213-2740
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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