Healthcare Provider Details

I. General information

NPI: 1437660834
Provider Name (Legal Business Name): CHRISTOS GEORGE LEMONIS CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 10/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10420 PARK RD STE 100A
CHARLOTTE NC
28210-8501
US

IV. Provider business mailing address

10420 PARK RD STE 100A
CHARLOTTE NC
28210-8501
US

V. Phone/Fax

Practice location:
  • Phone: 704-557-0700
  • Fax: 704-307-2871
Mailing address:
  • Phone: 704-557-0700
  • Fax: 704-307-2871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberPRO114
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberC52629
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: