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1376562108
LISA JERVIS
CHARLOTTE, NC
NPI
1376562108
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207V00000X Obstetrics & Gynecology
(Licence: NC 9900072)
Enumeration Date
2006-07-19
Last Update Date
2021-08-18
Business Address
LISA JERVIS
125 QUEENS RD STE 500
CHARLOTTE, NC 28204-3215
Phone number: 980-302-6380
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Mailing Address
LISA JERVIS
PO BOX 60447
CHARLOTTE, NC 28260-0447
Phone number: 980-302-6380
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