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General NPI Number Information
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NPI Number | 1033597067
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Entity Type | Organization
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Legal Business Name | ONSLOW SLEEP CLINIC, LLC
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 05/11/2015
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Provider Practice Location Address
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Address Line | 260 MEMORIAL DR STE A
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6332
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Country | US
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Telephone | 910-915-8341
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Fax | 910-758-2461
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Provider Business Mailing Address
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Address Line | PO BOX 148
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City | STELLA
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State | NC
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Zip | 28582-0148
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Country | US
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Telephone | 910-326-4956
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Fax | 910-326-6481
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Authorized Official
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Title or Position | MANAGER
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Name | MS. PATRICIA R MCCUTCHEON
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Credential |
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Telephone | 910-326-4956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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