Organization
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Active
Other names
Goodlife Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LEIZMAN (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
6650 RAMSEY ST, FAYETTEVILLE, NC 28311-9318
(910) 630-5203
Mailing address
5500 MARYLAND WAY STE 200, BRENTWOOD, TN 37027-4973
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/09/2014
Last updated
10/13/2022
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