| NPI | 1063690246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN MILLISENT JONES Co Owner/Qualified Professional 919-544-5871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 302E00000X) |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2008-04-09 |