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Organization
MOUNTCASTLE MEDICAL & MED SPA PLLC
Active
Organization
MOUNTCASTLE MEDICAL & MED SPA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY N MOUNTCASTLE PA-C (MEMBER, ORGANIZER, OWNER, CEO, PA-C)
(910) 890-6590
Entity
Organization
Contact information
Practice address
701 S MAIN ST, LILLINGTON, NC 27546-7681
(910) 984-1152
(910) 984-1171
Mailing address
701 S MAIN ST, LILLINGTON, NC 27546-7681
(910) 984-1152
(910) 984-1171
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
NULL
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
NULL
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
NULL
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/25/2021
Last updated
07/12/2021
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