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General NPI Number Information
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NPI Number | 1760147193
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Entity Type | Organization
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Legal Business Name | PAL SYSTEMS INC
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 1313 CRANE CRES
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-5662
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Country | US
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Telephone | 757-289-8273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749
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City | RIPLEY
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State | NY
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Zip | 14775-0749
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Country | US
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Telephone | 757-289-8273
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LESLIE HALL FENTON
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Credential | MD PHD FACP
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Telephone | 757-289-8273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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