| NPI | 1073644928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY MARK SLOAN Owner 910-270-0997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 9501103) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |