| NPI | 1073985693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA IZQUIERDO Physician Assistant 336-802-2105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC 0010-04334) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |