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9420 Philbeck Ln Wake Forest NC 27587-1608 | |
| (813) 966-7111 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 9420 Philbeck Ln, Wake Forest, North Carolina |
| Authorized Official Name and Position | Elizabeth Kirby (OWNER) |
| Authorized Official Contact | 8139667111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5981 Jones Farm Rd Wake Forest NC 27587-3603 Ph: (813) 966-7111 | 9420 Philbeck Ln Wake Forest NC 27587-1608 Ph: (813) 966-7111 |
| NPI Number | 1639901440 |
|---|---|
| Provider Enumeration Date | 08/19/2024 |
| Last Update Date | 08/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639901440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
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