Individual
MR. WILLIE CHRISTMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16691 1ST ST, ALVA, FL 33920-4119
(239) 728-3998
(239) 728-3998
Mailing address
16691 1ST ST, ALVA, FL 33920-4119
(239) 728-3998
(239) 728-3998
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906393
FL
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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