Provider Demographics
NPI:1225565484
Name:SYMPTOMETRY OF NORTH CAROLINA
Entity Type:Organization
Organization Name:SYMPTOMETRY OF NORTH CAROLINA
Other - Org Name:SUSTAINING LIFE WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMSU
Authorized Official - Middle Name:BATIN
Authorized Official - Last Name:BEY EL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-456-9183
Mailing Address - Street 1:3410 HEALY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1575
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3410 HEALY DR STE 104
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1575
Practice Address - Country:US
Practice Address - Phone:336-456-9183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC124171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1386178168OtherACUPUNCTURE