| Life Source, Pc | |
|
1108 Kentworth Dr Suite 704 Holly Springs NC 27540-3325 | |
| (919) 552-9952 | |
| (919) 552-3062 |
| Full Name | Life Source, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1108 Kentworth Dr, Holly Springs, North Carolina |
| Authorized Official Name and Position | Feyisayo Adeyina (OWNER) |
| Authorized Official Contact | 9195529952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Source, Pc 1108 Kentworth Dr Suite 704 Holly Springs NC 27540-3325 Ph: (919) 552-9952 | Life Source, Pc 1108 Kentworth Dr Suite 704 Holly Springs NC 27540-3325 Ph: (919) 552-9952 |
| NPI Number | 1124460985 |
|---|---|
| Provider Enumeration Date | 07/22/2013 |
| Last Update Date | 07/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124460985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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