Individual
GLORYGRACE DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 PAMALEE DR, FAYETTEVILLE, NC 28301-2824
(910) 488-2295
Mailing address
3402 CARL STEINER RD, FAYETTEVILLE, NC 28311-1646
(910) 584-7353
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4807
NC
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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