Organization
KZB
Active
Organization
KZB
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BERKLIN (PROFESSIONAL TRAINER)
(706) 577-2986
Entity
Organization
Contact information
Practice address
1114TH 16TH COURT SOUTH, PHENIX, AL 36869
(706) 577-2986
Mailing address
1114TH 16TH COURT SOUTH, PHENIX, AL 36869
(706) 577-2986
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
120927
CA
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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