Organization
HEADACHE WELLNESS CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL C FREEMAN MD (CO OWNER)
(336) 574-8000
Entity
Organization
Contact information
Practice address
1414 YANCEYVILLE STREET, FIRST FLOOR, GREENSBORO, NC 27405-6930
(336) 574-8000
(336) 574-8008
Mailing address
1414 YANCEYVILLE STREET, FIRST FLOOR, GREENSBORO, NC 27405-6930
(336) 574-8000
(336) 574-8008
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
84461
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101N
BCBSNC ID
NC
05
—
89015YM
—
NC
Enumeration date
04/25/2006
Last updated
08/01/2007
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