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Individual

AVERY SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9926 GOOSE LANDING DR, CHARLOTTE, NC 28269-5038
(704) 965-5371
Mailing address
9926 GOOSE LANDING DR, CHARLOTTE, NC 28269-5038
(704) 965-5371

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
000025764653
NC

Other

Enumeration date
01/05/2022
Last updated
01/05/2022
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