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General NPI Number Information
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NPI Number | 1396702619
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Entity Type | Organization
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Legal Business Name | LASER SKIN CARE PLLC
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 750 COX RD
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City | GASTONIA
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State | NC
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Zip | 28054-3481
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Country | US
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Telephone | 704-867-7212
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Fax | 704-867-7655
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Provider Business Mailing Address
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Address Line | 750 COX RD
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City | GASTONIA
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State | NC
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Zip | 28054-3481
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Country | US
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Telephone | 704-867-7212
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Fax | 704-867-7655
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES HUBERT HUTCHINS
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Credential | M.D.
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Telephone | 704-867-7212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17069
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License Number State | NC
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