# MLP CHURCH MD FAMILY PRACTICE, INC.

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

## Provider details

- **NPI number:** 1710215538
- **Authorized official:** DR. MARY LOUISE PARKER CHURCH MD (PRESIDENT / OWNER)
- **Authorized official phone:** (336) 667-6363

## Contact information

- **Practice address:** 1707 INDUSTRIAL DR, WILKESBORO, NC 28697-7345
- **Practice address phone:** (336) 667-6363
- **Practice address fax:** (336) 667-8066
- **Mailing address:** 1707 INDUSTRIAL DR, WILKESBORO, NC 28697-7345
- **Mailing address phone:** (336) 667-6363
- **Mailing address fax:** (336) 667-8066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/07/2009
- **Last updated:** 12/07/2009