# GOLDSBORO WELLNESS CENTER,PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659501930
- **Authorized official:** SHANNON R JIMENEZ D.O (OWNER)
- **Authorized official phone:** (919) 778-1676

## Contact information

- **Practice address:** 1100 PARKWAY DR, SUITE C, GOLDSBORO, NC 27534-3477
- **Practice address phone:** (919) 778-7665
- **Practice address fax:** (919) 778-7665
- **Mailing address:** 2600 US HIGHWAY 70 W, GOLDSBORO, NC 27530-7779
- **Mailing address phone:** (919) 739-4808
- **Mailing address fax:** (919) 739-4810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 9900553 | NC | Yes |

## Other

- **Enumeration date:** 07/21/2009
- **Last updated:** 02/09/2017