| NPI | 1124084702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMETT FULCHER MONTGOMERY Owner/Family Practice Physician 704-664-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2007-10-31 |