| NPI | 1093778110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KISHBAUGH Manager Member/Owner 910-486-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2011-12-08 |