| NPI | 1134787385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JOHNSTON Owner 336-508-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-03 |