LIFESOURCE OF NORTH CAROLINA

WILMINGTON, NC
NPI1811286156
Entity TypeOrganization
Authorized ContactPEGGY L BADDOUR
President/Owner
910-777-9165
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies363A00000X Physician Assistant
363L00000X Nurse Practitioner
103TC0700X Psychologist, Clinical
1041C0700X Social Worker, Clinical
207Q00000X Family Medicine
2084P0800X Psychiatry & Neurology, Psychiatry
Enumeration Date2011-04-06
Last Update Date2021-12-29
Business Address
LIFESOURCE OF NORTH CAROLINA
3205 RANDALL PKWY SUITE 105
WILMINGTON, NC 28403
Phone number: 910-742-9243
Mailing Address
LIFESOURCE OF NORTH CAROLINA
PO BOX 538622 LIFESOURCE OF NORTH CAROLINA
ATLANTA, GA 30353-8622
Phone number: 910-742-9243