Organization
BJUTIFUL SOUL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KJUANA DIGGS (MANAGER)
(704) 961-8218
Entity
Organization
Contact information
Practice address
8510 MCALPINE PARK DR STE 209, CHARLOTTE, NC 28211-6250
(980) 494-0011
Mailing address
12830 ENGLISH WALNUT LN, CHARLOTTE, NC 28215-5027
(704) 961-8218
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
12/24/2019
Last updated
12/24/2019
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