| Senior Health Source | |
|
3440 Toringdon Way Suite 205 Charlotte NC 28277-3190 | |
| (877) 747-5520 | |
| (877) 539-5520 |
| Full Name | Senior Health Source |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3440 Toringdon Way, Charlotte, North Carolina |
| Authorized Official Name and Position | Lewis Evans (OWNER) |
| Authorized Official Contact | 8777475520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Health Source 3440 Toringdon Way Suite 205 Charlotte NC 28277-3190 Ph: (877) 747-5520 | Senior Health Source 3440 Toringdon Way Suite 205 Charlotte NC 28277-3190 Ph: (877) 747-5520 |
| NPI Number | 1316256555 |
|---|---|
| Provider Enumeration Date | 10/06/2010 |
| Last Update Date | 10/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316256555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3909 (North Carolina) | Primary |
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