| NPI | 1134328636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MITCHELL Director Of Operations 704-532-6369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-07-13 |