NPI | 1003028655 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES PINCKNEY President 704-875-1026 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: 305R00000X) |
Enumeration Date | 2007-05-04 |
Last Update Date | 2020-08-22 |