| NPI | 1033380423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY L RICHARDSON Owner 910-452-7988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 5744) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2008-03-13 |