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General NPI Number Information
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NPI Number | 1871068908
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Entity Type | Organization
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Legal Business Name | RIDGELINE PSYCHIATRY
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 6 SHADOWBROOK DR
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City | WEAVERVILLE
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State | NC
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Zip | 28787-9444
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Country | US
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Telephone | 828-335-6763
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Fax |
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Provider Business Mailing Address
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Address Line | 6 SHADOWBROOK DR
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City | WEAVERVILLE
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State | NC
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Zip | 28787-9444
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Country | US
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Telephone | 828-333-5399
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOEL PURYEAR
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Credential | PA-C
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Telephone | 828-335-6763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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