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Organization
NOVANT MEDICAL GROUP INC
Active
Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Lakeside Physical Therapy & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (MANAGED CARE MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
14330 OAKHILL PARK LN STE 115, HUNTERSVILLE, NC 28078-3479
(704) 316-1265
(704) 316-1266
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-1635
(704) 316-1636
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/13/2013
Last updated
08/17/2021
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