Organization
SUPPLEMENTAL HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY DNISTRAN (SENIOR STAFFING MANAGER)
(919) 781-9565
Entity
Organization
Contact information
Practice address
2626 GLENWOOD AVE, SUITE 160, RALEIGH, NC 27608-1043
(919) 781-9565
(919) 781-9564
Mailing address
2626 GLENWOOD AVE, SUITE 160, RALEIGH, NC 27608-1043
(919) 781-9564
(919) 781-9564
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0542
NC
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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