| Graceful Aging,pc | |
|
2732 Bardolino Dr Fayetteville NC 28306-4636 | |
| (910) 868-6477 | |
| Not Available |
| Full Name | Graceful Aging,pc |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 2732 Bardolino Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Susannah Ogunwo (PRESIDENT) |
| Authorized Official Contact | 9108686477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Graceful Aging,pc Po Box 87142 Fayetteville NC 28304-7142 Ph: (910) 868-6477 | Graceful Aging,pc 2732 Bardolino Dr Fayetteville NC 28306-4636 Ph: (910) 868-6477 |
| NPI Number | 1316259013 |
|---|---|
| Provider Enumeration Date | 07/09/2010 |
| Last Update Date | 07/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316259013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 200601059 (North Carolina) | Primary |
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