| NPI | 1124165659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ALEXANDER TOLSON Owner 252-338-0373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 72895) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2012-08-13 |