Eastside Ventures Inc.

NPI #1578697660 in Oneonta, Alabama

Provider Information

NPI Number: 1578697660
Entity Type: Organization
Organization Name: Eastside Ventures Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: EASTSIDE VENTURES, INC.
Primary Specialty: Family Medicine
Enumeration Date: Mar 14, 2007
Last Updated: Feb 3, 2011

Practice Location

Address: 150 GILBREATH DR
Address 2: SUITE 201
City: Oneonta
State: Alabama
ZIP Code: 35121-2827
Phone: (205) 274-3055

Authorized Official

Name: MRS. VICKI H PARKS, CPA
Title: CHIEF ACCOUNTING OFFICER
Phone: (205) 838-3718

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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