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General NPI Number Information
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NPI Number | 1720726193
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Entity Type | Organization
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Legal Business Name | AVANT WELLNESS PLLC
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 9835 MONROE ROAD
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City | CHARLOTTE
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State | NC
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Zip | 28270-1471
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Country | US
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Telephone | 704-537-0909
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Fax | 704-537-0947
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Provider Business Mailing Address
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Address Line | 9835 MONROE ROAD
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City | CHARLOTTE
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State | NC
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Zip | 28270-1471
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Country | US
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Telephone | 704-537-0909
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Fax | 704-537-0947
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Authorized Official
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Title or Position | MEMBER
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Name | STEPHEN B LEWIS
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Credential | MD
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Telephone | 704-537-0909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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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 | 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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Taxonomy #3
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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