Organization
CHARLOTTE RECONSTRUCTIVE SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILLY MOORE (ACCOUNTING MANAGER)
(704) 971-1438
Entity
Organization
Contact information
Practice address
2215 RANDOLPH RD, CHARLOTTE, NC 28207-1523
(704) 971-1438
(704) 688-3899
Mailing address
2215 RANDOLPH RD, CHARLOTTE, NC 28207-1523
(704) 971-1438
(704) 688-3899
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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