Individual
MR. RONALD BACZURIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
847 W LAKE DR, MOUNT AIRY, NC 27030-2157
(336) 783-6919
(336) 783-6923
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1894
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2776
NC
103T00000X
Psychologist
1845
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6104976
—
NC
Enumeration date
06/25/2006
Last updated
07/31/2013
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