| Dtna - Gastonia | |
|
2605 Green Meadow Dr Gastonia NC 28052-7406 | |
| (704) 586-8292 | |
| (704) 865-1158 |
| Full Name | Dtna - Gastonia |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2605 Green Meadow Dr, Gastonia, North Carolina |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dtna - Gastonia 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Dtna - Gastonia 2605 Green Meadow Dr Gastonia NC 28052-7406 Ph: (704) 586-8292 |
| NPI Number | 1972279388 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 08/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972279388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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