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General NPI Number Information
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NPI Number | 1063118669
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Entity Type | Organization
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Legal Business Name | JON MICHELE, LLC
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 525 N MAIN ST
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City | WAYNESVILLE
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State | NC
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Zip | 28786-3817
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Country | US
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Telephone | 828-550-6814
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 780
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City | WAYNESVILLE
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State | NC
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Zip | 28786-0780
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEISA DENTI
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Credential |
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Telephone | 828-550-6814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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