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Organization

IMMANUEL FAMILY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BETTI D REESE MD (PRESIDENT)
(336) 856-9996
Entity
Organization

Contact information

Practice address
5500 W FRIENDLY AVE, SUITE 201, GREENSBORO, NC 27410-4212
(336) 856-9996
Mailing address
5500 W FRIENDLY AVE, SUITE 201, GREENSBORO, NC 27410-4212
(336) 856-9996

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89016JV
NC
Enumeration date
04/18/2006
Last updated
12/10/2007
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