NPI | 1003099409 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES HENRY PRIDGEN Medical Director 910-251-7715 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 29495) |
Enumeration Date | 2007-12-10 |
Last Update Date | 2012-05-17 |