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653 Bluefield Rd Ste B Mooresville NC 28117 | |
| (980) 444-2630 | |
| (980) 444-2631 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Occupational Medicine |
| Location | 653 Bluefield Rd, Mooresville, North Carolina |
| Authorized Official Name and Position | Carla D Johnson (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7044953162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 896199 Charlotte NC 28289-6199 Ph: (833) 936-1364 | 653 Bluefield Rd Ste B Mooresville NC 28117 Ph: (980) 444-2630 |
| NPI Number | 1780061424 |
|---|---|
| Provider Enumeration Date | 05/01/2015 |
| Last Update Date | 07/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780061424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QX0100X | Clinic/center - Occupational Medicine | (* (Not Available)) | Primary |
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