Organization
MOORESVILLE PPM LLC
Active
Parent organization
MOORESVILLE PPM LLC
Other names
The Center for Surgical Weight Loss
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOORESVILLE PPM LLC
Authorized official
MRS. JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
131 MEDICAL PARK RD, SUITE 303, MOORESVILLE, NC 28117-8522
(704) 660-4584
(704) 660-4967
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7230
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
01/04/2012
Last updated
01/14/2022
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