Healthcare Provider Details

I. General information

NPI: 1699273508
Provider Name (Legal Business Name): PURE PROACTIVE HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 FAYETTEVILLE ST FL 3
RALEIGH NC
27601-3030
US

IV. Provider business mailing address

555 FAYETTEVILLE ST FL 3
RALEIGH NC
27601-3030
US

V. Phone/Fax

Practice location:
  • Phone: 877-677-8767
  • Fax: 877-677-8767
Mailing address:
  • Phone: 877-677-8767
  • Fax: 877-677-8767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM M FERRO
Title or Position: FOUNDER
Credential: DC
Phone: 877-677-8767