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Organization

PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C

Active
Other names
DTNA - Mt. Holly
Organization subpart
No

Provider details

NPI number
Authorized official
JON LEIZMAN MD (PRESIDENT)
(216) 479-9063
Entity
Organization

Contact information

Practice address
1800 N MAIN ST, MOUNT HOLLY, NC 28120-9141
(704) 822-7301
(704) 822-7488
Mailing address
5500 MARYLAND WAY, BRENTWOOD, TN 37027-7048

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
08/10/2021
Last updated
08/24/2022
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