| Prosource Therapeutics, Llc | |
|
7356 Us Highway 64 Robersonville NC 27871-9073 | |
| (252) 353-7025 | |
| (252) 353-7028 |
| Full Name | Prosource Therapeutics, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7356 Us Highway 64, Robersonville, North Carolina |
| Authorized Official Name and Position | Phyllis Smith (ADMINISTRATOR) |
| Authorized Official Contact | 2523537025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosource Therapeutics, Llc 102 Fox Haven Dr #a Greenville NC 27858-9720 Ph: (252) 353-7025 | Prosource Therapeutics, Llc 7356 Us Highway 64 Robersonville NC 27871-9073 Ph: (252) 353-7025 |
| NPI Number | 1578799664 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 06/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578799664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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