Organization
SOUTHEN TRANQUILITY MEDISPA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLTON REID BEAMAN JR. PA-C (MEDICAL DIRECTOR/OWNER)
(252) 308-0686
Entity
Organization
Contact information
Practice address
130 CARDINAL DR, ROANOKE RAPIDS, NC 27870-4946
(252) 365-4440
(252) 308-0862
Mailing address
130 CARDINAL DR, ROANOKE RAPIDS, NC 27870
(252) 365-4440
(252) 308-0862
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
101911
NC
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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