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Organization

MODERNDAY WELLNESS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARQUITA WALLACE BOGGESS NP (NP)
(704) 737-9643
Entity
Organization

Contact information

Practice address
903 NORTHEAST DR STE 102, DAVIDSON, NC 28036-7437
(704) 737-9643
(980) 231-0080
Mailing address
5123 CHEVIOT RD, CHARLOTTE, NC 28269-4526
(704) 502-5372

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
03/19/2019
Last updated
03/19/2019
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