Individual
ROBBIE TYRONE CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 AMHURST ST SW, CONCORD, NC 28025-8838
(704) 794-8790
Mailing address
411 AMHURST ST SW, CONCORD, NC 28025-8838
(704) 794-8790
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274178413EIN
—
NC
Enumeration date
06/13/2012
Last updated
06/13/2012
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