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General NPI Number Information
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NPI Number | 1891257697
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Entity Type | Organization
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Legal Business Name | BA SKINNER GROUP INC.
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 04/02/2019
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Provider Practice Location Address
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Address Line | 1575 AVIATION CENTER PKWY STE 525
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-3864
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Country | US
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Telephone | 386-566-8565
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Fax |
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Provider Business Mailing Address
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Address Line | 1575 AVIATION CENTER PKWY STE 525
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-3864
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Country | US
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Telephone | 386-566-8565
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Fax |
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Authorized Official
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Title or Position | PRTESIDENT
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Name | MR. BRADLEY A SKINNER
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Credential |
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Telephone | 386-566-8565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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