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1700087756
TIM S. VANDERGAST
CONCORD, NC
NPI
1700087756
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: NC 45941)
Enumeration Date
2007-05-29
Last Update Date
2007-07-08
Business Address
-- TIM S. VANDERGAST MA, NCC
952 COPPERFIELD BLVD NE
CONCORD, NC 28025-2433
Phone number: 704-786-7709
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Mailing Address
-- TIM S. VANDERGAST MA, NCC
3967 TENNEYSON CT
CONCORD, NC 28027-8119
Phone number: 704-210-8450
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