| NPI | 1124693338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIXIE WINSLOW Executive Assistant 704-525-6288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |