Organization
SUNDANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN LANE PTA (TPM)
(919) 658-9522
Entity
Organization
Contact information
Practice address
228 SMITH CHAPEL ROAD, MOUNT OLIVE, NC 28365
(919) 658-9522
Mailing address
228 SMITH CHAPEL ROAD, MOUNT OLIVE, NC 28365
(919) 658-9522
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
A1737
NC
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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