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152 East Kinderton Way Suite 101 Advance NC 27006-7350 | |
| (336) 940-2781 | |
| (336) 940-2782 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 152 East Kinderton Way, Advance, North Carolina |
| Authorized Official Name and Position | Grace E Terrell (PRESIDENT/CEO) |
| Authorized Official Contact | 3368022400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1701 Westchester Drive Suite 850 High Point NC 27262-7254 Ph: (336) 802-2536 | 152 East Kinderton Way Suite 101 Advance NC 27006-7350 Ph: (336) 940-2781 |
| NPI Number | 1598096034 |
|---|---|
| Provider Enumeration Date | 01/22/2010 |
| Last Update Date | 05/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598096034 | NPI | - | NPPES |
| 5913407 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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