Individual
MR. CAVIN FERTIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS CCC SLP
Contact information
Practice address
12706 WOODROSE CT, CHARLOTTE, NC 28262-1543
(704) 549-0623
Mailing address
12706 WOODROSE CT, CHARLOTTE, NC 28262-1543
(704) 549-0623
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6728
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7412067
—
NC
Enumeration date
12/15/2006
Last updated
07/09/2007
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