Most Relevant Information
Provider Data
| NPI Number: | 1003067695 |
| Provider Name: | JEFF RANDALL MISHOE D.MIN. |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP1600X |
| Specialty: | Counselor |
| License Number: | 15 |
Most Important Dates
| Enumeration Date: | 10/01/2008 |
| Last Updated: | 10/01/2008 |
Provider Practice Location
310 EAST BLVD
C-8
CHARLOTTE
NC
282034891
Practice Location Phone/Fax
| Phone: | 7043441100 |
| Fax: | 7043441100 |
Provider Mailing Location
310 EAST BLVD
C-8
CHARLOTTE
NC
282034891
Provider Mailing Phone/Fax
| Phone: | 7043441100 |
| Fax: | 7043441100 |