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General NPI Number Information
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NPI Number | 1578827267
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Entity Type | Organization
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Legal Business Name | MISSION ON THE MOVE MINISTRIES INC.
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 3945 YEAGER RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-3852
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Country | US
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Telephone | 770-920-4796
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Fax |
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Provider Business Mailing Address
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Address Line | 3945 YEAGER RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-3852
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Country | US
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Telephone | 770-920-4796
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | MRS. CYNTHIA DIANE ANDREWS
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Credential |
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Telephone | 770-920-4796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number |
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License Number State |
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