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General NPI Number Information
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NPI Number | 1730325796
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Entity Type | Organization
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Legal Business Name | EKR, LLC
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 9734 ASHBURTON DR SUITE 101
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City | CHARLOTTE
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State | NC
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Zip | 28216-2195
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Country | US
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Telephone | 980-253-6516
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Fax |
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Provider Business Mailing Address
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Address Line | 9734 ASHBURTON DR SUITE 101
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City | CHARLOTTE
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State | NC
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Zip | 28216-2195
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Country | US
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Telephone | 980-253-6516
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. TONDRA C. MCLAURIN
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Credential | LPC
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Telephone | 980-253-6516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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