Provider Demographics
NPI:1033521935
Name:DURCHHOLZ, ALLISON MARIE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:DURCHHOLZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 QUARTERS LANDING CIR APT 605
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-8318
Mailing Address - Country:US
Mailing Address - Phone:217-899-5002
Mailing Address - Fax:
Practice Address - Street 1:131 RACINE DR
Practice Address - Street 2:SUITE 100A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8777
Practice Address - Country:US
Practice Address - Phone:910-784-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051296947183500000X
NC24016183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist