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Organization
PROSOURCE THERAPEUTICS, LLC
Active
Organization
PROSOURCE THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS SMITH (OWNER)
(252) 353-7025
Entity
Organization
Contact information
Practice address
622 EAST BLVD, WILLIAMSTON, NC 27892-2736
(252) 353-7025
Mailing address
102 FOX HAVEN DR, SUITE A, GREENVILLE, NC 27858-9720
(252) 353-7025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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