Healthcare Provider Details

I. General information

NPI: 1396023073
Provider Name (Legal Business Name): REMEDY CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2011
Last Update Date: 07/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4822 SIX FORKS RD 202
RALEIGH NC
27609-5269
US

IV. Provider business mailing address

4822 SIX FORKS RD 202
RALEIGH NC
27609-5269
US

V. Phone/Fax

Practice location:
  • Phone: 919-788-1568
  • Fax:
Mailing address:
  • Phone: 919-788-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number312
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number3664
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number05561
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number834
License Number StateNC

VIII. Authorized Official

Name: VIRGINIA A BROWNING
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 919-788-1568