Club Haven Family Practice
Club Haven Family Practice is a Specialist in Winston Salem, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.
- Licensed in
- NC
- In the registry since
- 2006
Practice location Address checks out
2801 Lyndhurst AveWinston Salem, NC 27103-4109
Phone: (336) 768-9575
Fax: (336) 774-1737
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence 40378/30659 (NC) |
|---|
Record details
| NPI number | 1902869829 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Thomas Jolly — Owner · (336) 768-9575 |
| NPI enumerated | April 11, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 2801 Lyndhurst Ave, Winston-Salem, NC 27103-4109 |
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