Individual
KEVIN MEDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8601 DUNSINANE DR, CHARLOTTE, NC 28227-2629
(336) 577-3712
Mailing address
506 WELSH ST, MONROE, NC 28112-4556
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
376G00000X
Nursing Home Administrator
Primary
FCL-060-121
NC
Other
Enumeration date
11/28/2011
Last updated
06/26/2012
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