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Organization

EL SANCTUARY

Active
Other names
The Sanctuary
Organization subpart
No

Provider details

NPI number
Authorized official
DR. QETSIYAH S YISRAEL PHD (DIRECTOR)
(919) 351-9814
Entity
Organization

Contact information

Practice address
4501 NEW BERN AVE, #130-196, RALEIGH, NC 27610-1549
(919) 351-9814
(919) 255-6119
Mailing address
4501 NEW BERN AVE, #130-196, RALEIGH, NC 27610-1549
(919) 351-9814
(919) 255-6119

Taxonomy

Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary

Other

Enumeration date
06/27/2011
Last updated
06/27/2011
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