Organization
ORTHONC ASC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA JOHNSON (DIRECTOR OF CLINICAL OPERATIONS)
(919) 562-9410
Entity
Organization
Contact information
Practice address
11221 GALLERIA AVE STE 105, RALEIGH, NC 27614-8137
(919) 562-9410
Mailing address
PO BOX 1107, WAKE FOREST, NC 27588-1107
(919) 562-9410
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
06/01/2022
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