| NPI | 1013231943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTONIO SPENCER President 336-378-2511 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC 200100470) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-25 |