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Spencer Faircloth

Student in an Organized Health Care Education/Training Program in Charlotte, NC. Individual provider (NPI-1).

NPI number1316640642
StatusActive
Last updated in NPPESMar 24, 2023

Details

NPI
1316640642
Entity type
Individual (NPI-1)
Name
Spencer Faircloth
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 24, 2023
Certification date
Mar 24, 2023
Last updated
Mar 24, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

1503 Kirk Farm Ln Apt 103
Charlotte, NC 28213-4049

Phone 910-670-5421

Mailing address

1503 Kirk Farm Ln Apt 103
Charlotte, NC 28213-4049

Phone 910-670-5421

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