| Providence Pediatric Functional Medicine, Pllc | |
|
610 N Fayetteville St Ste 102 Asheboro NC 27203-4671 | |
| (336) 233-7882 | |
| Not Available |
| Full Name | Providence Pediatric Functional Medicine, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 610 N Fayetteville St Ste 102, Asheboro, North Carolina |
| Authorized Official Name and Position | Nicole Anderson (OWNER/AUTHORIZED OFFICIAN) |
| Authorized Official Contact | 3362337882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Pediatric Functional Medicine, Pllc 610 N Fayetteville St Ste 102 Asheboro NC 27203-4671 Ph: (336) 233-7882 | Providence Pediatric Functional Medicine, Pllc 610 N Fayetteville St Ste 102 Asheboro NC 27203-4671 Ph: (336) 233-7882 |
| NPI Number | 1710810437 |
|---|---|
| Provider Enumeration Date | 06/03/2026 |
| Last Update Date | 06/06/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710810437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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