| NPI | 1073594305 |
|---|---|
| Doing Business As | WESTERN STANLY PRIMARY CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS SCOTT FORTH CEO 704-983-8756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2020-08-22 |