| NPI | 1063696565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTIE LOWE Owner 910-791-7067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NC FCH065011) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2007-12-20 |