Healthcare Provider Details

I. General information

NPI: 1245134030
Provider Name (Legal Business Name): STONE WELLNESS FARM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 RAEFORD RD
FAYETTEVILLE NC
28305-5028
US

IV. Provider business mailing address

4030 WAKE FOREST RD STE 349
RALEIGH NC
27609-0010
US

V. Phone/Fax

Practice location:
  • Phone: 910-633-2464
  • Fax: 844-444-0917
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHNNIE STONE
Title or Position: OWNER
Credential:
Phone: 910-633-2464