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COLE HOUSTON DEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
910 E INNES ST, SALISBURY, NC 28144-4638
(980) 330-6898
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12913
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/21/2022
Last updated
07/10/2024
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