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119-d-1 Marketplace Avenue Mooresville NC 28117-9157 | |
| (704) 801-9160 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 119-d-1 Marketplace Avenue, Mooresville, North Carolina |
| Authorized Official Name and Position | Thomas Laymon (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 7044468250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | 119-d-1 Marketplace Avenue Mooresville NC 28117-9157 Ph: (704) 801-9160 |
| NPI Number | 1275080954 |
|---|---|
| Provider Enumeration Date | 09/09/2016 |
| Last Update Date | 02/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275080954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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