Provider Demographics
NPI:1093273435
Name:MOHEBALI, JAMSHID
Entity Type:Individual
Prefix:
First Name:JAMSHID
Middle Name:
Last Name:MOHEBALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-2530
Mailing Address - Country:US
Mailing Address - Phone:828-375-0076
Mailing Address - Fax:
Practice Address - Street 1:108 E 1ST ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2530
Practice Address - Country:US
Practice Address - Phone:828-375-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1027171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist