Organization
CENTRIX MEDICAL MANAGEMENT, LLC
Active
Other names
C.H.E.S.T
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ETHAN THEOPHILUS RPSGT (PRESIDENT)
(919) 605-2155
Entity
Organization
Contact information
Practice address
1135 KILDAIRE FARM RD, SUITE 200, CARY, NC 27511-7608
(180) 065-6794
(187) 722-6707
Mailing address
1135 KILDAIRE FARM RD, SUITE 200, CARY, NC 27511-7608
(180) 065-6794
(187) 722-6707
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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