Individual
MISS KIARA JO FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 N COOL SPRING ST, FAYETTEVILLE, NC 28301-5137
(910) 323-4925
Mailing address
5421 HEATHER ST, HOPE MILLS, NC 28348-2846
(910) 423-0380
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
NC
Other
Enumeration date
01/02/2008
Last updated
01/02/2008
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