Individual
COLLIN BARRETT MERCURI STAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
808 HOUSTON CT, HAW RIVER, NC 27258-8853
(315) 720-2121
Mailing address
808 HOUSTON CT, HAW RIVER, NC 27258-8853
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
302079
NC
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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