| NPI | 1003916131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL P PROVOST President 828-586-8971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2009-08-04 |