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Organization

DIAGON THERAPUTIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TRACI SCOTT MORROW (THERAPIST)
(704) 890-2192
Entity
Organization

Contact information

Practice address
413 W MAIN AVE, SUITE 120, GASTONIA, NC 28052-3896
(704) 890-2192
(704) 974-6213
Mailing address
296 SACCO ST, BELMONT, NC 28012-3059

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6115013
NC
Enumeration date
08/01/2012
Last updated
08/03/2012
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