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Organization
LIFE SOURCE, PC
Active
Organization
LIFE SOURCE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FEYISAYO ADEYINA MD (OWNER)
(919) 552-9952
Entity
Organization
Contact information
Practice address
1108 KENTWORTH DR, SUITE 704, HOLLY SPRINGS, NC 27540-3325
(919) 552-9952
(919) 552-3062
Mailing address
1108 KENTWORTH DR, SUITE 704, HOLLY SPRINGS, NC 27540-3325
(919) 552-9952
(919) 552-3062
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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