NPI 1326437989

Executive Image, INC.

Organisation Physiological Laboratory Winston Salem, NC

Practice location

Address: 470 W Hanes Mill Rd Suite 107, Winston Salem, NC 27105-9102
Phone: (336) 918-6328
Fax: (800) 840-4241

Authorised official

Name: Diana B Goolsby
Title: President/Ceo
Phone: (336) 918-6328

Registered specialties

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X

Other Physiological Laboratory providers in North Carolina →

Registry record

NPI: 1326437989
Entity type: Organization
NPI issued: 20 Jan 2015
Record last updated: 20 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.