Individual
BERRY DEWAYNE AYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
325 PAGE RD N STE 3, PINEHURST, NC 28374-0088
(910) 295-2828
Mailing address
PO BOX 4754, PINEHURST, NC 28374-4754
(910) 295-2828
(910) 295-2996
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
02948
GA
224P00000X
Prosthetist
02948
GA
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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