Organization
LANEY WELLNESS CENTER
Active
Parent organization
WILMINGTON HEALTH ACCESS FOR TEENS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILMINGTON HEALTH ACCESS FOR TEENS, INC
Authorized official
MARIA VAN DE BOVENKAMP CMA(AAMA) (DIRECTOR OF ADMINISTRATION)
(910) 790-9949
Entity
Organization
Contact information
Practice address
4005 OLEANDER DR, WILMINGTON, NC 28403-6816
(910) 790-9949
(910) 790-9455
Mailing address
2700 N COLLEGE RD, WILMINGTON, NC 28405-8816
(910) 790-9949
(910) 790-9455
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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