| Pec Ltc PA | |
|
4692 Brownsboro Rd Winston Salem NC 27106-3410 | |
| (336) 251-1114 | |
| (336) 251-1117 |
| Full Name | Pec Ltc PA |
|---|---|
| Speciality | General Practice |
| Location | 4692 Brownsboro Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Christopher Herman (PRESIDENT) |
| Authorized Official Contact | 3362511114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pec Ltc PA 4692 Brownsboro Rd Winston Salem NC 27106-3410 Ph: (336) 251-1114 | Pec Ltc PA 4692 Brownsboro Rd Winston Salem NC 27106-3410 Ph: (336) 251-1114 |
| NPI Number | 1306519152 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 07/28/2021 |
| Certification Date | 07/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306519152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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