Organization
RISING INTEGRATIVE HEALTHCARE OF WILMINGTON, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN M KEAN (AUTHORIZED OFFICIAL)
(910) 530-3031
Entity
Organization
Contact information
Practice address
5 SILVA TERRA DR STE 100, WILMINGTON, NC 28412-2373
(910) 530-3031
Mailing address
504 RED BANKS RD STE C, GREENVILLE, NC 27858-5766
(252) 321-3579
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200301497
NC MEDICAL BOARD LICENSE
NC
Enumeration date
05/22/2019
Last updated
07/31/2023
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