| |
4132 Hickory Blvd Granite Falls NC 28630-8371 | |
(828) 396-3168 | |
(828) 396-8783 |
Full Name | |
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Speciality | Family Medicine |
Location | 4132 Hickory Blvd, Granite Falls, North Carolina |
Authorized Official Name and Position | Denise Lowry (PRACTICE MANAGER) |
Authorized Official Contact | 8283963283 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4132 Hickory Blvd Po Box 965 Granite Falls NC 28630-8371 Ph: (828) 396-3168 | 4132 Hickory Blvd Granite Falls NC 28630-8371 Ph: (828) 396-3168 |
NPI Number | 1861685364 |
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Provider Enumeration Date | 08/20/2007 |
Last Update Date | 04/05/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861685364 | NPI | - | NPPES |
19642 | Other | NC | BC |
8919642 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 29829 (North Carolina) | Primary |