INDIAN TRAIL FAMILY MEDICINE

INDIAN TRAIL, NC
NPI1003842782
Entity TypeOrganization
Authorized ContactDANIEL L WIENS
Senior Vice President
704-355-0648
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2006-06-24
Last Update Date2008-02-12
Business Address
INDIAN TRAIL FAMILY MEDICINE
4503 OLD MONROE RD
INDIAN TRAIL, NC 28079-5309
Phone number: 704-821-6900
Mailing Address
INDIAN TRAIL FAMILY MEDICINE
5000 AIRPORT CENTER PKWY STE A
CHARLOTTE, NC 28208-5899
Phone number: 704-512-4116
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