| NPI | 1053692079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ANNE ZIMMERMAN Physician Assistant 336-740-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 101887) |
| Enumeration Date | 2011-09-03 |
| Last Update Date | 2011-09-03 |