| NPI | 1053595553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE SMALL Owner 252-492-2316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NC FCH091008) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2007-12-20 |