Organization
DIAMOND FAMILY PRACTICE, PLLC
Active
Other names
Lake Jeanette Urgent Care, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY M BOAZE N.P. (ORGANIZING MEMBER/OWNER)
(336) 601-0812
Entity
Organization
Contact information
Practice address
1309 LEES CHAPEL RD, GREENSBORO, NC 27455-2601
(336) 286-5505
(336) 286-5583
Mailing address
1309 LEES CHAPEL RD, GREENSBORO, NC 27455-2601
(336) 286-5505
(336) 286-5583
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/08/2006
Last updated
11/17/2011
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