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1386204923
BERRY DEWAYNE AYCOCK
PINEHURST, NC
NPI
1386204923
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
222Z00000X Orthotist
(Licence: GA 02948)
Additional Taxonomies
224P00000X Prosthetist
(Licence: GA 02948)
Enumeration Date
2019-06-17
Last Update Date
2019-06-17
Business Address
BERRY DEWAYNE AYCOCK CPO
325 PAGE RD N STE 3
PINEHURST, NC 28374-0088
Phone number: 910-295-2828
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Mailing Address
BERRY DEWAYNE AYCOCK CPO
PO BOX 4754
PINEHURST, NC 28374-4754
Phone number: 910-295-2828
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