| NPI | 1154521904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILISSA LYN ROWELL Administrator 910-343-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC NC9400118) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |