CAROLINA CONCUSSION & PHYSICAL MEDICINE, PLLC

WAKE FOREST, NC
NPI1124544499
Entity TypeOrganization
Authorized ContactMICHAEL S. DECRISCIO
Member
301-922-6188
Organization Subpart ?No
Primary Taxonomy111NR0400X 
(Licence: NC  4670)
Enumeration Date2017-08-18
Last Update Date2018-05-20
Business Address
CAROLINA CONCUSSION & PHYSICAL MEDICINE, PLLC
120 CAPCOM AVEUNE SUITE 104
WAKE FOREST, NC 27587
Phone number: 301-922-6188
Mailing Address
CAROLINA CONCUSSION & PHYSICAL MEDICINE, PLLC
7900 WOODCROSS WAY
WAKE FOREST, NC 27587-8328
Phone number: 301-922-6188
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