Individual
MR. VINCE MARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
219 ALBANY ST, BURLINGTON, NC 27215-7249
(336) 226-9716
(336) 226-9716
Mailing address
PO BOX 163, RANDLEMAN, NC 27317-0163
(336) 495-5647
(336) 495-5647
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-001-161
NC
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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