Healthcare Provider Details

I. General information

NPI: 1134050065
Provider Name (Legal Business Name): G & G B2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 HILLSBOROUGH ST STE 124
RALEIGH NC
27607-7162
US

IV. Provider business mailing address

3001 HILLSBOROUGH ST STE 124
RALEIGH NC
27607-7162
US

V. Phone/Fax

Practice location:
  • Phone: 919-616-7868
  • Fax:
Mailing address:
  • Phone: 919-616-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCUS BETHEA
Title or Position: FRANCHISOR
Credential:
Phone: 919-606-6423