Organization
YOUTH STARS
Active
Organization
YOUTH STARS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVON GILLIARD (DIRECTOR)
(336) 617-7908
Entity
Organization
Contact information
Practice address
102 TEAKWOOD DR, SUITE F, GREENSBORO, NC 27406-8185
(336) 617-7908
Mailing address
102 TEAKWOOD DR, SUITE F, GREENSBORO, NC 27406-8185
(336) 617-7908
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
01/27/2011
Last updated
02/04/2011
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