Individual
MRS. AMY FALES HARRELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3623 LATROBE DR STE 216, CHARLOTTE, NC 28211-2117
(704) 332-1291
Mailing address
PO BOX 221249, CHARLOTTE, NC 28222-1249
(704) 332-1291
(704) 332-5206
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
103935
NC
363A00000X
Physician Assistant
Primary
103935
NC
Other
Enumeration date
04/03/2006
Last updated
02/03/2023
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