| NPI | 1003858721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L WALLACE Assitant Administrator 336-714-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NC AS0044) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2012-10-12 |