Individual
CHARLES ALLAN PITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
965 E MT GILEAD RD, BOLIVAR, MO 65613-9128
(417) 327-6104
Mailing address
965 E MT GILEAD RD, BOLIVAR, MO 65613-9128
(417) 327-6104
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
S063269009
MO
344600000X
Taxi
T981478106
MO
Other
Enumeration date
10/26/2018
Last updated
10/30/2018
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