Organization
FREEDOM HEALTHCARE
Active
Other names
DBA ALLIANCE UROLOGY SPECIALISTS, PA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WILDA M YOUNG PT (PRESIDENT)
(336) 274-1114
Entity
Organization
Contact information
Practice address
509 N ELAM AVE FL 2, GREENSBORO, NC 27403-1157
(336) 274-1114
(336) 232-5325
Mailing address
509 N ELAM AVE FL 2, GREENSBORO, NC 27403-1157
(336) 274-1114
(336) 232-5325
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07120
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
10/27/2009
Last updated
10/27/2009
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