| NPI | 1003482795 |
|---|---|
| Doing Business As | SOUTHEASTERN MEDICAL CLINIC TANGLEWOOD |
| Entity Type | Organization |
| Authorized Contact | ELLA HUNT Credentialing 910-737-3147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |