Healthcare Provider Details

I. General information

NPI: 1053393272
Provider Name (Legal Business Name): CELO HEALTH EDUCATION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 SEVEN MILE RIDGE RD
BURNSVILLE NC
28714-8509
US

IV. Provider business mailing address

116 SEVEN MILE RIDGE RD
BURNSVILLE NC
28714-8509
US

V. Phone/Fax

Practice location:
  • Phone: 828-675-4116
  • Fax: 828-675-9312
Mailing address:
  • Phone: 828-675-4116
  • Fax: 828-675-9312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBORA BARNETT
Title or Position: OFFICE MANAGER
Credential:
Phone: 828-675-4116