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1780035816
LAURA ICENHOUR BUCHANAN
CHARLOTTE, NC
NPI
1780035816
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-06582)
Enumeration Date
2016-06-30
Last Update Date
2024-07-15
Business Address
LAURA ICENHOUR BUCHANAN PA
1001 BLYTHE BLVD
CHARLOTTE, NC 28203-5866
Phone number: 704-381-9900
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Mailing Address
LAURA ICENHOUR BUCHANAN PA
PO BOX 19305
CHARLOTTE, NC 28219-9305
Phone number:
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