Individual
JANINE L GREGOLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
124 WELTON WAY, MOORESVILLE, NC 28117-9163
(704) 658-1050
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2090
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-00065
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730029
NSC #
NC
Enumeration date
07/25/2006
Last updated
08/31/2021
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