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General NPI Number Information
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NPI Number | 1346672201
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Entity Type | Organization
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Legal Business Name | BOB INMAN INCORPORATED
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 3410 LAINEY LN B
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-2541
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Country | US
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Telephone | 910-609-1800
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Fax | 704-885-9974
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Provider Business Mailing Address
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Address Line | PO BOX 35333
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-0333
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Country | US
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Telephone | 910-609-1800
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Fax | 704-885-9974
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DEVON INMAN
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Credential | BA, QP
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Telephone | 910-609-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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