Israel Fornville
Driver in Greenville, NC. Individual provider (NPI-1).
NPI number1275242562
StatusActive
Last updated in NPPESNov 16, 2022
Details
- NPI
- 1275242562
- Entity type
- Individual (NPI-1)
- Name
- Israel Fornville
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 16, 2022
- Certification date
- Nov 16, 2022
- Last updated
- Nov 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172A00000X | Driver | 7937489 | NC | Yes |
Practice location
105 Kimberley DrGreenville, NC 27858-6722
Phone 252-757-1758 · Fax 252-830-0077
Mailing address
105 Kimberley DrGreenville, NC 27858-6722
Phone 252-757-1758 · Fax 252-830-0077
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All 15 Driver providers in Greenville · All 7,137 providers in Greenville
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