Individual
AMELIA FRYE LEVISTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10650 PARK RD, STE 480 A, CHARLOTTE, NC 28210-8538
(704) 355-1813
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11210
NC
Other
Enumeration date
06/16/2022
Last updated
07/15/2024
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