# BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Table Rock Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952626384
- **Authorized official:** PATRICIA MOLL (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (910) 671-5472

## Contact information

- **Practice address:** 301 LINVILLE STREET, GLEN ALPINE, NC 28628
- **Practice address phone:** (828) 584-2481
- **Practice address fax:** (828) 584-8371
- **Mailing address:** 301 LINVILLE ST, MORGANTON, NC 28655-7206
- **Mailing address phone:** (828) 584-2481
- **Mailing address fax:** (828) 584-8371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | NULL | — |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NC | Yes |

## Other

- **Enumeration date:** 03/29/2010
- **Last updated:** 03/14/2025