Organization
CLEVELAND NEUROLOGIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY MARTIN (PHYSICIAN/OWNER)
(704) 471-9895
Entity
Organization
Contact information
Practice address
1180 WYKE RD, SUITE B, SHELBY, NC 28150-4259
(704) 471-9895
(704) 471-9200
Mailing address
1180 WYKE RD, SUITE B, SHELBY, NC 28150-4259
(704) 471-9895
(704) 471-9200
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
729676
NC
Other
Enumeration date
05/26/2006
Last updated
11/06/2008
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