MR. State Witherspoon Alexander IV

NPI #1144604315 in Charlotte, North Carolina

Provider Information

NPI Number: 1144604315
Entity Type: Individual
Name: MR. State Witherspoon Alexander IV
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Jul 16, 2015
Last Updated: Jul 16, 2015

Practice Location

Address: 8933 RAVEN PARK DR
City: Charlotte
State: North Carolina
ZIP Code: 28216-1685
Phone: (704) 307-3009

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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