| NPI | 1053515460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN O'HARE President 704-375-3218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NC 1647) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |