Individual
MR. MICHAEL ANTON FACKLMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNFA
Contact information
Practice address
1001 BLYTHE BLVD, SUITE 300, CHARLOTTE, NC 28203-5866
(704) 373-0212
(704) 373-2626
Mailing address
1001 BLYTHE BLVD, SUITE 300, CHARLOTTE, NC 28203-5866
(704) 373-0212
(704) 373-2626
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
0001206848
VA
Other
Enumeration date
10/22/2009
Last updated
10/22/2009
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