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Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Carolina Family Practice & Sports Medicine-Cary
Organization subpart
No
Provider details
NPI number
Authorized official
VALLA F WILSON (CHIEF COMPLIANCE PRIVACY & AUDIT OF)
(919) 668-5161
Entity
Organization
Contact information
Practice address
3700 NW CARY PKWY, STE. 110, CARY, NC 27513-8446
(919) 238-2000
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
09/19/2012
Last updated
07/11/2022
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