Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-07-27
- Last updated
- 2023-10-30
Licenses
- License DE
- A3-0000809
Location
- Practice location
- 1215 S STATE ST
- City
- DOVER DE
- Postal code
- 199016927
- Phone
- 302-730-1170
Organization contact
- Name
- KIRA TAYLOR
- Title
- MANAGER
- Phone
- 2177092351
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.