Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2008-05-27
- Last updated
- 2014-06-13
Licenses
- License NC
- 2670
- License NC
- 2670
Location
- Practice location
- 318A E MAIN ST
- City
- HAVELOCK NC
- Postal code
- 285322214
- Phone
- 252-447-7764
Organization contact
- Name
- PATRICIA DICKINSON
- Title
- Owner
- Phone
- 2524477764
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.