| Premise Health Clinic | |
|
5501 Josh Birmingham Pkwy # B11b12 Charlotte NC 28208-5750 | |
| (704) 343-5006 | |
| (704) 359-0900 |
| Full Name | Premise Health Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 5501 Josh Birmingham Pkwy # B11b12, Charlotte, 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 |
|---|---|
| Premise Health Clinic 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Clinic 5501 Josh Birmingham Pkwy # B11b12 Charlotte NC 28208-5750 Ph: (704) 343-5006 |
| NPI Number | 1053838912 |
|---|---|
| Provider Enumeration Date | 08/23/2017 |
| Last Update Date | 08/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053838912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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