Prosource Therapeutics, Llc | |
622 East Blvd Williamston NC 27892-2736 | |
(252) 353-7025 | |
Not Available |
Full Name | Prosource Therapeutics, Llc |
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Speciality | Social Worker - Clinical |
Location | 622 East Blvd, Williamston, North Carolina |
Authorized Official Name and Position | Phyllis Smith (OWNER) |
Authorized Official Contact | 2523537025 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Prosource Therapeutics, Llc 102 Fox Haven Dr Suite A Greenville NC 27858-9720 Ph: (252) 353-7025 | Prosource Therapeutics, Llc 622 East Blvd Williamston NC 27892-2736 Ph: (252) 353-7025 |
NPI Number | 1811158546 |
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Provider Enumeration Date | 06/25/2008 |
Last Update Date | 06/25/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811158546 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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