Organization
DYNAMIC GROUP SERVICES
Active
Other names
Dynamic Group Services
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA BAZEMORE (PRESIDENT)
(252) 258-5176
Entity
Organization
Contact information
Practice address
505 SUNSET AVE STE B, ROCKY MOUNT, NC 27804-5616
(919) 673-8240
Mailing address
8911 ELIZABETH BENNET PL, RALEIGH, NC 27616-9050
(252) 258-5176
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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