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General NPI Number Information
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NPI Number | 1467136994
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Entity Type | Organization
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Legal Business Name | ELITE STICKS TESTING LLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 2763 TOBACCO RD STE B
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City | HEPHZIBAH
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State | GA
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Zip | 30815-7051
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Country | US
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Telephone | 207-987-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 2763 TOBACCO RD STE B
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City | HEPHZIBAH
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State | GA
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Zip | 30815-7051
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Country | US
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Telephone | 207-987-1665
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMIKA SMITH
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Credential |
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Telephone | 706-469-8440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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