| NPI | 1134149842 |
|---|---|
| Other Name | J BLAKE GOSLEN MD PA |
| Entity Type | Organization |
| Authorized Contact | GIRISH MUNAVALLI Medical Director 704-375-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |