NPI 1114290632
Ballantyne Medical Associates PLLC
Practice location
- Address
- 12311 Copper Way Suite 100, Charlotte, NC 28277-3642
- Phone
- (704) 540-1640
- Mailing address
- 2980 N Beverly Glen Cir Suite 301, Los Angeles, CA 90077-1726
Authorised official
- Name
- Carlos Jorge
- Title
- Owner
- Phone
- (704) 540-1640
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1114290632
- Entity type
- Organization
- NPI issued
- 14 Feb 2012
- Record last updated
- 14 Feb 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.