# MAIN STREET FAMILY PRACTICE OF CHINA GROVE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619279247
- **Authorized official:** MS. KIM PURCELL-REID PA-C (OWNER)
- **Authorized official phone:** (704) 857-8769

## Contact information

- **Practice address:** 302 S MAIN ST, CHINA GROVE, NC 28023-2471
- **Practice address phone:** (704) 857-8769
- **Practice address fax:** (704) 857-8779
- **Mailing address:** 302 S MAIN ST, CHINA GROVE, NC 28023-2471
- **Mailing address phone:** (704) 857-8769
- **Mailing address fax:** (704) 857-8779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/02/2010
- **Last updated:** 12/02/2010