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Organization

NC MEDTECH PLLC

Active
Other names
Metrolina Plastic Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BROC LANE PRATT M.D. (PRESIDENT)
(704) 541-7654
Entity
Organization

Contact information

Practice address
10620 PARK RD, SUITE 102, CHARLOTTE, NC 28210-8472
(305) 866-9951
(877) 284-8933
Mailing address
10620 PARK RD, SUITE 102, CHARLOTTE, NC 28210-8472
(704) 541-7654

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
77796
NC
261QM2500X
Medical Specialty Clinic/Center
77796
NC

Other

Enumeration date
08/28/2008
Last updated
03/11/2010
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