Provider Demographics
NPI:1689789059
Name:MOTLOW, CONSTANCE HUDSON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:HUDSON
Last Name:MOTLOW
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:CONSTANCE
Other - Middle Name:HUDSON
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:405 EAST CENTER STREET
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292
Mailing Address - Country:US
Mailing Address - Phone:336-248-5623
Mailing Address - Fax:336-248-6722
Practice Address - Street 1:405 EAST CENTER STREET
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292
Practice Address - Country:US
Practice Address - Phone:336-248-5623
Practice Address - Fax:336-248-6722
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7134183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist