NPI | 1033307483 |
---|---|
Entity Type | Organization |
Authorized Contact | VERNON GARRISON Director 252-791-0030 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 99242) |
Enumeration Date | 2007-10-11 |
Last Update Date | 2007-10-11 |