Individual
CHARLES MAURICE PHIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 TOM HUNTER RD, CHARLOTTE, NC 28213-5511
(704) 900-5513
Mailing address
PO BOX 480777, CHARLOTTE, NC 28269-5306
(704) 965-5377
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8342
NC
Other
Enumeration date
07/15/2012
Last updated
07/15/2012
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