Mooresville Ppm, LLC
NPI #1003567082 in Statesville, North Carolina
Provider Information
- NPI Number
- 1003567082
- Entity Type
- Organization
- Organization Name
- Mooresville Ppm, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MOORESVILLE PPM, LLC
- Primary Specialty
- Internal Medicine - Interventional Cardiology
- Enumeration Date
- Jan 12, 2022
- Last Updated
- Jan 12, 2022
Practice Location
- Address
- 1424 FERN CREEK DR STE D
- City
- Statesville
- State
- North Carolina
- ZIP Code
- 28625-9376
- Phone
- (704) 878-2058
Authorized Official
- Name
- JENNIFER L JACKSON
- Title
- SR DIR PROV ENROLL & ONBOARDING
- Phone
- (615) 465-3334
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Interventional Cardiology — Interventional Cardiology |
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