| NPI | 1124559331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILAR DAVIDSON Practice Manager 828-612-4383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 5005188) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005188) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2020-03-27 |