Organization
ADVANCE REHABILITATION AND NURSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER A EZEIGBO MD (CEO)
(336) 940-2659
Entity
Organization
Contact information
Practice address
169 YADKIN VALLEY RD, SUITE 101, ADVANCE, NC 27006-8786
(336) 940-2659
Mailing address
5515 FRESH FIELD LN, WINSTON SALEM, NC 27106-6262
(336) 940-2659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9601605
NC
Other
Enumeration date
10/04/2011
Last updated
10/04/2011
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