# PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** US11 Michelin Occupational Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124452586
- **Authorized official:** JON LEIZMAN M.D. (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 40589 S STANLY SCHOOL RD, NORWOOD, NC 28128-8752
- **Practice address phone:** (704) 474-2011
- **Practice address fax:** (704) 784-8179
- **Mailing address:** 5500 MARYLAND WAY, BRENTWOOD, TN 37027-4948
- **Mailing address phone:** (704) 474-2011
- **Mailing address fax:** (704) 784-8179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2013
- **Last updated:** 08/24/2022