Individual
DEANGELO BETHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
97 HEAVEN LN, SAINT PAULS, NC 28384-8788
(910) 309-5612
Mailing address
PO BOX 746, SAINT PAULS, NC 28384-0746
(910) 309-5612
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
NC
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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