| NPI | 1093219370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL MARS HOWERTON Sr VP Network Phys & Hs Cmo 336-716-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-11-08 |