| Organization Name: | PURE MED SPA HUNTERSVILLE PLLC |
| NPI Number: | 1023445079 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIGGS EDWARD COOK (OWNER/PHYSICIAN) |
| Mailing Address: | 10210 Hickorywood Hill Ave Suite 100 Huntersville |
| State: | NC US |
| Postal Code: | 280783332 |
| Phone Number: | 7044507563 |
| Fax Number: | 7042884202 |
| NPI Enumeration Date: | 10/07/2013 |
| NPI Last Update Date: | 10/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS0132X |
| License Number: | 2001-0037 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ophthalmologic Surgery |
| Taxonomy Definition: | |