Organization
BOTTOM UP OUTREACH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WHALEY (PRESIDENT)
(336) 995-8370
Entity
Organization
Contact information
Practice address
554 BEDFORD KNOLL DR, WINSTON SALEM, NC 27107-2023
(336) 995-8370
Mailing address
554 BEDFORD KNOLL DR, WINSTON SALEM, NC 27107-2023
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
17053251337009
NC
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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