Healthcare Provider Details

I. General information

NPI: 1306741418
Provider Name (Legal Business Name): ADVANCED LASER SPECIALISTS OF CHEROKEE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 ACQUONI RD
CHEROKEE NC
28719
US

IV. Provider business mailing address

1108 ACQUONI RD
CHEROKEE NC
28719
US

V. Phone/Fax

Practice location:
  • Phone: 678-634-7142
  • Fax:
Mailing address:
  • Phone: 678-634-7142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CARMEN ELIZABETH JOHNSON
Title or Position: FOOT & ANKLE SURGERY PODIATRIST
Credential: D.P.M
Phone: 678-634-7142