Individual
MARY E HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2826 MARCUS JAMES DRIVE, FAYETTEVILLE, NC 28306
(716) 548-8967
Mailing address
2826 MARCUS JAMES DRIVE, FAYETTEVILLE, NC 28306
(716) 548-8967
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT60069254
WA
Other
Enumeration date
08/17/2006
Last updated
07/19/2012
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