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Organization
VITA MEDICAL CARE CLINIC, PLLC
Active
Organization
VITA MEDICAL CARE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKISHA D PURDIE (PRACTICE MANAGER)
(910) 677-9488
Entity
Organization
Contact information
Practice address
2911 BREEZEWOOD AVE, SUITE 101, FAYETTEVILLE, NC 28303
(910) 677-9488
(910) 677-9491
Mailing address
2911 BREEZEWOOD AVE, SUITE 101, FAYETTEVILLE, NC 28303
(910) 677-9488
(910) 677-9491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
08/15/2012
Last updated
02/02/2017
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