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Organization
SOUTHEAST STONE CENTER
Active
Organization
SOUTHEAST STONE CENTER
Active
Other names
Southeast Stone Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY H RUSSELL (BUSINESS SERVICES COORDINATOR)
(704) 896-2120
Entity
Organization
Contact information
Practice address
705 GRIFFITH ST STE 205, DAVIDSON, NC 28036-9307
(866) 828-0173
Mailing address
705 GRIFFITH ST STE 205, PO BOX 4509, DAVIDSON, NC 28036-9307
(866) 828-0173
Taxonomy
Speciality
Code
Description
License number
State
261QL0400X
Lithotripsy Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/22/2007
Last updated
08/22/2020
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