Provider Demographics
NPI:1447521364
Name:NEUROSENSORY CENTER OF CHARLOTTE
Entity type:Organization
Organization Name:NEUROSENSORY CENTER OF CHARLOTTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:ANSON
Authorized Official - Last Name:HALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:704-746-3942
Mailing Address - Street 1:14330 OAKHILL PARK LN
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3314
Mailing Address - Country:US
Mailing Address - Phone:704-746-3942
Mailing Address - Fax:
Practice Address - Street 1:14330 OAKHILL PARK LN
Practice Address - Street 2:SUITE 140
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3314
Practice Address - Country:US
Practice Address - Phone:704-746-3942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center