Organization
NCTI AND HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON GARRISON (DIRECTOR)
(252) 791-0030
Entity
Organization
Contact information
Practice address
215 US HIGHWAY 64 W, PLYMOUTH, NC 27962-2239
(252) 791-0030
(252) 791-0060
Mailing address
215 US HIGHWAY 64 W, PLYMOUTH, NC 27962-2239
(252) 791-0030
(252) 791-0060
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
99242
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301684
—
NC
Enumeration date
10/11/2007
Last updated
10/11/2007
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