Provider Demographics
NPI:1821239351
Name:TCT SUCCESS
Entity Type:Organization
Organization Name:TCT SUCCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WITHROW
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:704-692-6057
Mailing Address - Street 1:9700 RESEARCH DR
Mailing Address - Street 2:SUITE 143
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8552
Mailing Address - Country:US
Mailing Address - Phone:704-405-8095
Mailing Address - Fax:704-405-8096
Practice Address - Street 1:9700 RESEARCH DR
Practice Address - Street 2:SUITE 143
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8552
Practice Address - Country:US
Practice Address - Phone:704-405-8095
Practice Address - Fax:704-405-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service