Organization
LICE CLINICS OF AMERICA - GULF COAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI CUMMINGS (CERTIFIED TECHNICIAN/OWNER)
(251) 660-4312
Entity
Organization
Contact information
Practice address
9078 MERRITT LN, SUITE D, DAPHNE, AL 36526-5614
(251) 660-4312
Mailing address
9078 MERRITT LN, SUITE D, DAPHNE, AL 36526-5614
(251) 660-4312
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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