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Organization
LAKE NORMAN INTEGRATIVE PSYCHIATRY
Active
Organization
LAKE NORMAN INTEGRATIVE PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY THOMPSON LATZ M.D., M.S. (SOLE OWNER)
(704) 662-3200
Entity
Organization
Contact information
Practice address
116 S MAIN ST STE 301, MOORESVILLE, NC 28115-2373
(704) 662-3200
(704) 662-1247
Mailing address
116 S MAIN ST STE 301, P.O. BOX 1247, MOORESVILLE, NC 28115-2373
(704) 662-3200
(704) 662-8731
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
34660
NC
Other
Enumeration date
05/11/2007
Last updated
10/03/2007
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