Colonel, Clover Marjorie
Colonel, Clover Marjorie is an sole proprietor health care provider with primary practice located at 1040 S Church St , Burlington NC 27215-5046. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotic Fitter, Suppliers / Prosthetic/Orthotic Supplier. Suppliers / Prosthetic/Orthotic Supplier is her primary health care specialty. Colonel, Clover Marjorie can be contacted via phone (336) 222-8052.Contact Information
Primary practice address
1040 S Church St
Burlington NC 27215-5046
Phone: (336) 222-8052
Fax: (336) 222-8091
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotic Fitter | 225000000X | ||
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | North Carolina |
Profile Details
| NPI number | 1831346964 |
|---|---|
| LBN Legal business name | Colonel, Clover Marjorie |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2008 |
| Last updated | Oct 25th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831346964 | NPPES |
| North Carolina | MEDICAID | 7795167 |
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