Healthcare Provider Details

I. General information

NPI: 1801874359
Provider Name (Legal Business Name): MICHELE RENEE PUTNAM DC DIPL AC NCCAOM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10320 MALLARD CREEK RD STE 210
CHARLOTTE NC
28262-9756
US

IV. Provider business mailing address

17329 KNOXWOOD DR
HUNTERSVILLE NC
28078-5214
US

V. Phone/Fax

Practice location:
  • Phone: 704-226-4444
  • Fax: 866-459-1051
Mailing address:
  • Phone: 704-591-1457
  • Fax: 866-459-1051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number015812
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberSC1989
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberNC2319
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: