Mooresville Ppm LLC
NPI #1215214127 in Mooresville, North Carolina
Provider Information
- NPI Number
- 1215214127
- Entity Type
- Organization
- Organization Name
- Mooresville Ppm LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MOORESVILLE PPM LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 5, 2011
- Last Updated
- Jan 14, 2022
Practice Location
- Address
- 417 E STATESVILLE AVE
- City
- Mooresville
- State
- North Carolina
- ZIP Code
- 28115-2590
- Phone
- (704) 663-2389
Authorized Official
- Name
- JENNIFER L JACKSON
- Title
- SR DIR PROV ENROLL & ONBOARDING
- Phone
- (615) 465-3334
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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