| NPI | 1083051643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE MORTON Cmo 704-607-4835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036132088) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2025-07-23 |