1174310528 NPI Owner Practice Location
NPI : 1174310528
Status: Deactivated (CMS Deactivated NPI)
Deactivation Date: 01/29/2026
CMS deactivated NPI 1174310528.
The provider can no longer use this NPI.
HIPAASpace.com public NPI registry does not display provider information about NPIs that are not in service.