| NPI | 1104097138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL CUMMINGS Administrator 910-671-0052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: NC 100452) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-09-09 |