Community Practitioner Program
Dashboard
date-266
2021-08-23
Professional
Physician Asstistant
PracticeName
New Bern-Clinic
MonthYearStartedPracticingCurrentSite
2021-08-01
PracticeCity
New bern
Practice
28411
OfficePhone
9106125782
HomeAddress
7134 Ner bern
HomeState
NC
HomeCounty
new bern
NCMedicalBoardLicenseNumber
13245-2345
checkbox-589
No
checkbox-924
No
textarea-514
ry, and a motion simulator. The riverside Cape Fear Botanical Garden has plant species like camellias and daffodils, pl
PercentageofPractice
1234
practicebusinessmanager
Ty Ben
EmailAddress
tb@gmail.com
practitionerssalary
150,000
Signature
Ty bEee
file-233
Sequence Number
your-name
Pete Rose
Type
Primary Care
MonthYearStartedPracticing
2021-08-05
PracticeAddress
2134543 New Bern Ave
PracticeState
NC
PracticeCounty
New bern
HomePhone
9106125782
HomeCity
New bern
HomeZip
28411
your-email
nb@gmail.com
checkbox-900
No
PracticesManagementStructureandPrincipalOwners
ry, and a motion simulator. The riverside Cape Fear Botanical Garden has plant species like camellias and daffodils, pl
Listallprovidersandtheirprofessionalstatus
ry, and a motion simulator. The riverside Cape Fear Botanical Garden has plant species like camellias and daffodils, pl
checkbox-864
Yes,No,No,No,No,No,Yes,No,Yes,No,Yes,No,No,No,No,No
NumberofPatients
1234
ContactNumber
555-555-5555
languagesspoken
n/a
Loanamount
90,000
date-533
2021-08-23
Entry ID
2021/08/24 at 2:27 pm