Organization
CPSC CMG LLC
Active
Other names
Carolinas Plastic Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
VALINDA L. RUTLEDGE (PRESIDENT, CEO)
(704) 834-2133
Entity
Organization
Contact information
Practice address
2391 COURT DR, STE 120, GASTONIA, NC 28054-2196
(704) 874-0095
(704) 866-8680
Mailing address
2391 COURT DR, STE 120, GASTONIA, NC 28054-2196
(704) 874-0095
(704) 866-8680
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5915163
—
NC
Enumeration date
06/23/2010
Last updated
02/03/2011
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