| NPI | 1083810501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOU ROLAND Account Specialist 336-623-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: VA 0101053359) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2008-03-10 |