Individual
MRS. DIANA TONG ROETTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 PROVIDENCE RD STE 100, CHARLOTTE, NC 28207-1242
(704) 333-9113
(704) 333-9757
Mailing address
2952 CRAFTSMAN LN, CHARLOTTE, NC 28204-4392
(512) 296-9112
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-04133
NC
Other
Enumeration date
03/12/2013
Last updated
11/20/2014
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