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9377 N Us Highway 301 # 670 Whitakers NC 27891-8621 | |
(252) 437-9211 | |
(252) 437-9774 |
Full Name | |
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Speciality | Clinic/center |
Location | 9377 N Us Highway 301 # 670, Whitakers, North Carolina |
Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 9377 N Us Highway 301 # 670 Whitakers NC 27891-8621 Ph: (252) 437-9211 |
NPI Number | 1467711523 |
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Provider Enumeration Date | 05/10/2012 |
Last Update Date | 08/24/2022 |
Identifier | Type | State | Issuer |
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1467711523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QX0100X | Clinic/center - Occupational Medicine | (* (Not Available)) | Secondary |