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General NPI Number Information
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NPI Number | 1467908368
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Entity Type | Organization
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Legal Business Name | LAKE NORMAN COMMUNICATION SERVICES, INC.
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 484 WILLIAMSON RD STE 102
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City | MOORESVILLE
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State | NC
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Zip | 28117-8191
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Country | US
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Telephone | 704-293-6552
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Fax |
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Provider Business Mailing Address
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Address Line | 484 WILLIAMSON RD STE 102
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City | MOORESVILLE
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State | NC
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Zip | 28117-8191
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Country | US
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Telephone | 704-793-8475
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAMELA SUSAN MANSER
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Credential |
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Telephone | 704-293-6552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4057
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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