LIFESOURCE OF NORTH CAROLINA is a general practice in Cheyenne, WY. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Source: National Uniform Claim Committee LIFESOURCE OF NORTH CAROLINA NPI is 1386144418. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
1208 E PERSHING BLVD
CHEYENNE, WY
ZIP 82001-230
Phone: (910) 742-9243
Fax: (888) 746-1787
The provider's authorized official is Peggy Baddour .
The authorized official title is President/owner and has the following contact phone number (910) 777-9165.
The enumeration date for this NPI number is 2/15/2018 and was last updated on 3/25/2021.