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1376804971
BALLANTYNE FAMILY MEDICINE PC
CHARLOTTE, NC
NPI
1376804971
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Entity Type
Organization
Authorized Contact
RICHARD T. WYNN
President
704-208-4134
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NC 2011-01795)
Enumeration Date
2012-05-31
Last Update Date
2016-02-24
Business Address
BALLANTYNE FAMILY MEDICINE PC
16147 LANCASTER HWY SUITE 140
CHARLOTTE, NC 28277-4782
Phone number: 704-208-4134
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Mailing Address
BALLANTYNE FAMILY MEDICINE PC
16147 LANCASTER HWY SUITE 140
CHARLOTTE, NC 28277-4782
Phone number: 704-208-4134
Copy
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