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Organization

MOUNTCASTLE MEDICAL & MED SPA PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDY N MOUNTCASTLE PA-C (MEMBER, ORGANIZER, OWNER, CEO, PA-C)
(910) 890-6590
Entity
Organization

Contact information

Practice address
701 S MAIN ST, LILLINGTON, NC 27546-7681
(910) 984-1152
(910) 984-1171
Mailing address
701 S MAIN ST, LILLINGTON, NC 27546-7681
(910) 984-1152
(910) 984-1171

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
207Q00000X
Family Medicine Physician
Primary
207QA0401X
Addiction Medicine (Family Medicine) Physician
207QS1201X
Sleep Medicine (Family Medicine) Physician
208VP0014X
Interventional Pain Medicine Physician
363A00000X
Physician Assistant

Other

Enumeration date
05/25/2021
Last updated
07/12/2021
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