Organization
GASTONIA PHYSICIAN SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM H LARSEN (DIRECTOR OF CREDENTIALING)
(770) 874-5468
Entity
Organization
Contact information
Practice address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 834-2000
(770) 874-5483
Mailing address
PO BOX 21107, BELFAST, ME 04915-4108
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
04/24/2014
Last updated
01/30/2020
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