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Organization
NC MEDTECH PLLC
Active
Organization
NC MEDTECH PLLC
Active
Other names
Metrolina Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROC LANE PRATT M.D. (PRESIDENT)
(704) 541-7654
Entity
Organization
Contact information
Practice address
10620 PARK RD, SUITE 102, CHARLOTTE, NC 28210-8472
(305) 866-9951
(877) 284-8933
Mailing address
10620 PARK RD, SUITE 102, CHARLOTTE, NC 28210-8472
(704) 541-7654
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
77796
NC
261QM2500X
Medical Specialty Clinic/Center
77796
NC
Other
Enumeration date
08/28/2008
Last updated
03/11/2010
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