| NPI | 1154399699 |
|---|---|
| Other Name | PRACTITIONER GROUP - GENERAL |
| Entity Type | Organization |
| Authorized Contact | C. THOMAS JOHNSON V. P. Finance 910-671-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC H0064) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2009-11-02 |