Organization
BOICE-WILLIS CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY FAZIO (CHIEF EXECUTIVE OFFICER)
(252) 937-0200
Entity
Organization
Contact information
Practice address
901 N WINSTEAD AVE, ROCKY MOUNT, NC 27804-8467
(252) 937-0200
(252) 443-0096
Mailing address
901 N WINSTEAD AVE, ROCKY MOUNT, NC 27804-8467
(252) 937-0200
(252) 443-0096
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
38821
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211225
—
NC
Enumeration date
08/18/2008
Last updated
10/04/2023
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