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Individual

MISS SUSAN YVONNE PRIDGEN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
A.T.C.-L

Contact information

Practice address
8409 LEESVILLE RD, RALEIGH, NC 27613-1004
(919) 870-4273
Mailing address
8308 AMBER LANTERN ST, APT 302, RALEIGH, NC 27613-4580
(919) 247-1213

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
04/06/2006
Last updated
07/08/2007
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