Organization
FAYETTEVILLE ALLSTAR WHEELCHAIR SPORTS TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROCHELLE MYLES MCCLAIN (OWNER)
(910) 273-3278
Entity
Organization
Contact information
Practice address
425 BRISTLECONE RD, FAYETTEVILLE, NC 28311-7698
(910) 273-3278
Mailing address
PO BOX 3066, FAYETTEVILLE, NC 28302-3066
(910) 273-3278
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
03/10/2014
Last updated
03/10/2014
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