Individual
JACQUELYN CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4046 GLENLEA COMMONS DR, CHARLOTTE, NC 28216-9515
(706) 412-3035
Mailing address
4046 GLENLEA COMMONS DR, CHARLOTTE, NC 28216-9515
(706) 412-3035
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/02/2014
Last updated
02/02/2014
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