| Harley Grace Llc | |
|
185 Wooster Rd Southern Pines NC 28387-2354 | |
| (910) 585-9074 | |
| Not Available |
| Full Name | Harley Grace Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 185 Wooster Rd, Southern Pines, North Carolina |
| Authorized Official Name and Position | Rose Moredock (OWNER) |
| Authorized Official Contact | 9105859074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harley Grace Llc 185 Wooster Rd Southern Pines NC 28387-2354 Ph: (910) 585-9074 | Harley Grace Llc 185 Wooster Rd Southern Pines NC 28387-2354 Ph: (910) 585-9074 |
| NPI Number | 1598216970 |
|---|---|
| Provider Enumeration Date | 10/20/2016 |
| Last Update Date | 10/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598216970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 8714 (North Carolina) | Primary |
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