Organization
FUNCTIONALCARE 360
Active
Other names
First Class Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JARRED FISHER PA-C (MEDICAL DIRECTOR)
(331) 442-5062
Entity
Organization
Contact information
Practice address
9828 AINSLIE DOWNS ST, CHARLOTTE, NC 28273-4976
(331) 442-5062
(681) 201-0332
Mailing address
9828 AINSLIE DOWNS ST, CHARLOTTE, NC 28273-4976
(331) 442-5062
(681) 201-0332
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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