Organization
KELLOGG MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN GOODSTAT LCSW (COO)
(704) 288-1097
Entity
Organization
Contact information
Practice address
10352 PARK RD, CHARLOTTE, NC 28210-8401
(704) 288-1097
Mailing address
10352 PARK RD, CHARLOTTE, NC 28210-8401
(704) 288-1097
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
11/27/2023
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