Organization
CHURCH FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LORI A CHURCH MD (OWNER)
(910) 755-7181
Entity
Organization
Contact information
Practice address
20 MEDICAL CAMPUS DR, SUITE 203, SUPPLY, NC 28462-4096
(910) 755-7181
(910) 755-7194
Mailing address
20 MEDICAL CAMPUS DR, SUITE 203, SUPPLY, NC 28462-4096
(910) 755-7181
(910) 755-7194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200701334
NC
Other
Enumeration date
09/13/2010
Last updated
09/13/2010
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