Provider Demographics
NPI:1326240045
Name:MCHARGUE, SUZANNE S (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:S
Last Name:MCHARGUE
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MEDICAL PARK DR
Mailing Address - Street 2:NORTHEAST INTERNAL AND INTEGRATIVE MEDICINE
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2971
Mailing Address - Country:US
Mailing Address - Phone:704-403-7050
Mailing Address - Fax:704-403-7059
Practice Address - Street 1:301 MEDICAL PARK DR
Practice Address - Street 2:NORTHEAST INTERNAL AND INTEGRATIVE MEDICINE
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2971
Practice Address - Country:US
Practice Address - Phone:704-403-7050
Practice Address - Fax:704-403-7059
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3339174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist