Organization
CLUB STAFFING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE E WALLCOEN (ULTRASOUND TECHNOLOGIST)
(704) 609-8095
Entity
Organization
Contact information
Practice address
146 HAYWOOD DR, RAEFORD, NC 28376-5314
(704) 609-8095
Mailing address
146 HAYWOOD DR, RAEFORD, NC 28376-5314
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
05/25/2007
Last updated
12/22/2008
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