| NPI | 1093104044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN P MARCO Owner 704-341-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 3803) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |