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Organization

PHYSICIANS CREDENTIALING SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEAH TISSUE (OWNER)
(256) 246-8634
Entity
Organization

Contact information

Practice address
2743 BOB WALLACE AVE SW STE D, HUNTSVILLE, AL 35805-4103
(256) 246-8634
(256) 937-7571
Mailing address
2743 BOB WALLACE AVE SW STE D, HUNTSVILLE, AL 35805-4103
(256) 246-8634
(256) 937-7571

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary

Other

Enumeration date
06/21/2024
Last updated
06/21/2024
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