Organization
MEDICAL ASSESSMENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAN LE BONNO LEBOZEC (PRESIDENT)
(980) 229-3722
Entity
Organization
Contact information
Practice address
4912 ALBEMARLE RD, CHARLOTTE, NC 28205-6618
(980) 229-3722
(704) 896-8193
Mailing address
4912 ALBEMARLE RD, CHARLOTTE, NC 28205-6618
(980) 229-3722
(704) 896-8193
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3547
NC
Other
Enumeration date
09/29/2012
Last updated
09/29/2012
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