Individual
JEFFREY FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 BILLINGSLEY RD STE 104, CHARLOTTE, NC 28211-1066
(704) 377-7099
(704) 377-7983
Mailing address
411 BILLINGSLEY RD STE 104, CHARLOTTE, NC 28211-1066
(704) 377-7099
(704) 377-7983
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891869780
—
NC
Enumeration date
01/08/2014
Last updated
01/08/2014
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