Organization Name: | R & B FLECK ENTERPRISES, LLC |
NPI Number: | 1225163926 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD WAYNE FLECK (PRESIDENT) |
Mailing Address: | 1365 Beet Rd Walla Walla |
State: | WA US |
Postal Code: | 993627180 |
Phone Number: | 5095201794 |
Fax Number: | 5095295860 |
NPI Enumeration Date: | 02/22/2007 |
NPI Last Update Date: | 02/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 252090019815 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |