Organization
KEITH & MOUSTAFA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUENARRL KEITH (OWNER)
(704) 749-3808
Entity
Organization
Contact information
Practice address
9635 SOUTHERN PINE BLVD STE 126, CHARLOTTE, NC 28273-5558
(704) 749-3808
(866) 408-8142
Mailing address
9635 SOUTHERN PINE BLVD STE 126, CHARLOTTE, NC 28273-5558
(704) 749-3808
(866) 408-8142
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/03/2011
Last updated
06/21/2011
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