Individual
RONITA STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR REPLACEMENT SPC
Contact information
Practice address
1100 CHARLES BLVD STE B, GREENVILLE, NC 27858-3300
(252) 364-2904
(252) 364-2904
Mailing address
1100 CHARLES BLVD STE B, GREENVILLE, NC 27858-3300
(252) 364-2904
(252) 364-2904
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
C84668
NC
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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