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1035 Dale Earnhardt Blvd Kannapolis NC 28083-4477 | |
| (704) 316-1886 | |
| (704) 316-1887 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1035 Dale Earnhardt Blvd, Kannapolis, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | 1035 Dale Earnhardt Blvd Kannapolis NC 28083-4477 Ph: (704) 316-1886 |
| NPI Number | 1144514662 |
|---|---|
| Provider Enumeration Date | 06/01/2011 |
| Last Update Date | 07/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144514662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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