Organization Name: | ADVANCED HEALTH AND PHYSICAL MEDICINE PLLC |
NPI Number: | 1083918338 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICTORIA MILLER KEAN (OWNER) |
Mailing Address: | 504-c Red Banks Rd Greenville |
State: | NC US |
Postal Code: | 278585766 |
Phone Number: | 2523213579 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2010 |
NPI Last Update Date: | 04/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |