Healthcare Provider Details

I. General information

NPI: 1053276329
Provider Name (Legal Business Name): BENOIT TRICHOLOGY & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 BRAGG BLVD STE 98
FAYETTEVILLE NC
28303-4386
US

IV. Provider business mailing address

1909 BRAGG BLVD STE 98
FAYETTEVILLE NC
28303-4386
US

V. Phone/Fax

Practice location:
  • Phone: 910-852-3024
  • Fax:
Mailing address:
  • Phone: 910-852-3024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MIZELIN BENOIT
Title or Position: OWNER
Credential:
Phone: 910-852-3024