| NPI | 1053695346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LEE BRISSON Pharmacist 910-862-3705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NC 05906) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-10 |