Individual
HOLLY MARIE O'GRADY VANBENCOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
327 ROCK CRUSHER RD, ASHEBORO, NC 27203-8477
(336) 636-5546
(336) 636-5145
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02105
NC
363AM0700X
Medical Physician Assistant
—
NC
Other
Enumeration date
10/15/2009
Last updated
01/31/2025
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