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Organization

CAROLINA ANTI-AGING & WELLNESS CENTER PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN WATSON DURHAM MD (PRESIDENT)
(919) 774-0502
Entity
Organization

Contact information

Practice address
1227 CARTHAGE ST, SANFORD, NC 27330-8984
(919) 774-0502
(919) 774-0505
Mailing address
1227 CARTHAGE ST, SANFORD, NC 27330-8984
(919) 774-0502
(919) 774-0505

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
39413
NC
261QP3300X
Pain Clinic/Center
39413
NC

Other

Enumeration date
05/28/2009
Last updated
05/28/2009
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