Organization
LIFE LINE CONNECTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAMESHA DENISE HARRIS (OWNER)
(704) 231-9481
Entity
Organization
Contact information
Practice address
9635 SOUTHERN PINE BLVD, CHARLOTTE, NC 28273-5558
(704) 231-9481
Mailing address
6210 CANDLEWOOD DR, CHARLOTTE, NC 28210-4506
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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