Organization
BALLANTYNE MEDICAL ASSOCIATES PLLC
Active
Parent organization
BALLANTYNE MEDICAL ASSOCIATES PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BALLANTYNE MEDICAL ASSOCIATES PLLC
Authorized official
DR. CARLOS JORGE M.D. (OWNER)
(704) 540-1640
Entity
Organization
Contact information
Practice address
12311 COPPER WAY, SUITE 100, CHARLOTTE, NC 28277-3642
(704) 540-1640
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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