Organization
LAKE NORMAN PAIN AND WEIGHT MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISSY GAYLE FOHR NPC (NURSE PRACTITIONER)
(336) 414-1164
Entity
Organization
Contact information
Practice address
378 WILLIAMSON RD STE 204, MOORESVILLE, NC 28117-5917
(704) 662-0009
(704) 360-2335
Mailing address
378 WILLIAMSON RD STE 204, MOORESVILLE, NC 28117-5917
(704) 662-0009
(704) 360-2335
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5004119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004603
—
NC
Enumeration date
09/10/2010
Last updated
03/18/2024
Update your record
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