Organization
BREECHES BUOY ADDICTION MEDICINE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLA HARDENBERGH (OWNER)
(208) 578-6110
Entity
Organization
Contact information
Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 536-1689
Mailing address
PO BOX 3870, FLORENCE, SC 29502-3870
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/04/2021
Last updated
03/20/2024
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