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General NPI Number Information
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NPI Number | 1295538379
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Entity Type | Organization
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Legal Business Name | CHARLOTTE FITNESS AND WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 3758 S MAIN ST STE 300
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City | HOPE MILLS
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State | NC
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Zip | 28348-1959
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Country | US
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Telephone | 910-429-0647
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Fax |
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Provider Business Mailing Address
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Address Line | 3626 LATROBE DR STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28211-1799
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Country | US
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Telephone | 704-366-7182
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Fax | 704-366-7184
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOEL ONAFOWOKAN
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Credential | MD
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Telephone | 704-366-7182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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