Provider Demographics
NPI:1568076222
Name:RALEIGH HOLISTIC HEALTHCARE
Entity Type:Organization
Organization Name:RALEIGH HOLISTIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOVLET
Authorized Official - Middle Name:JARRETT
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-749-6288
Mailing Address - Street 1:5109 SUNSET FAIRWAYS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7862
Mailing Address - Country:US
Mailing Address - Phone:336-740-2160
Mailing Address - Fax:
Practice Address - Street 1:875 WALNUT ST STE 275-9
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4215
Practice Address - Country:US
Practice Address - Phone:919-749-6288
Practice Address - Fax:919-443-1268
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVLET DAVIS MD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty