Organization
THE INSTITUTE OF LIFESTYLE AND WEIGHT MANAGEMENT
Active
Organization
THE INSTITUTE OF LIFESTYLE AND WEIGHT MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EZRA BROOKS WILKINS M.D. (PRESIDENT AND CEO)
(919) 791-1112
Entity
Organization
Contact information
Practice address
3100 DURALEIGH RD, SUITE 200, RALEIGH, NC 27612-8106
(919) 791-1112
Mailing address
3100 DURALEIGH RD, SUITE 200, RALEIGH, NC 27612-8106
(919) 791-1112
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
00987496
NC
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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