Premier Estates 504, LLC

Practice location

Address

102 E J Ave, Grundy Center, IA 50638-2031

Phone

(319) 824-5436

Fax

(319) 824-5808

Mailing address

5115 E State Road 64, Bradenton, FL 34208-5509

Authorised official

Name

Jamie Culp

Title

Controller

Phone

(941) 758-4745

Registered specialties

Registry record

NPI

1063878767

Entity type

Organization

NPI issued

11 Jan 2016

Record last updated

10 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.