Individual
MR. BOBBY EATMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5019 DORSEY RD, OXFORD, NC 27565-8305
(252) 213-1525
Mailing address
PO BOX 1558, OXFORD, NC 27565-1558
(252) 213-1525
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL039034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040968
FACILITY ID
NC
Enumeration date
02/27/2007
Last updated
07/08/2007
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