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General NPI Number Information
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NPI Number | 1740020122
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Entity Type | Organization
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Legal Business Name | WORKING FOR PROGRESS LLC
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 401 WINSTON AVE
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City | WILMINGTON
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State | DE
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Zip | 19804-1818
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Country | US
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Telephone | 302-290-5390
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Fax | 302-993-1029
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Provider Business Mailing Address
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Address Line | 401 WINSTON AVE
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City | WILMINGTON
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State | DE
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Zip | 19804-1818
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Country | US
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Telephone | 302-290-5390
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Fax | 302-993-1029
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | TONI STAFFORD
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Credential |
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Telephone | 903-948-8566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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