Organization
WELLLIFE:A DIABETES CLINIC AND EDUCATIONAL RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DWAN THOMPSON KELSEY NURSE PRACTITIONER (CEO)
(919) 624-6533
Entity
Organization
Contact information
Practice address
331 TRYON RD STE 103A, RALEIGH, NC 27603-3583
(919) 624-6533
Mailing address
331 TRYON RD STE 103A, RALEIGH, NC 27603-3583
(919) 624-6533
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
900229
NC
Other
Enumeration date
09/12/2007
Last updated
01/30/2009
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