Organization
SUPPLEMENTAL HEALTHCARE STAFFING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATHENA WILSON (RESPIRATORY THEARPIST)
(919) 698-9253
Entity
Organization
Contact information
Practice address
2626 GLENWOOD AVE, SUITE160, RALEIGH, NC 27608-1043
(919) 781-9565
(919) 781-9564
Mailing address
612 CECIL ST, DURHAM, NC 27707-3232
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
A-3203
NC
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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