NPI | 1154545952 |
---|---|
Entity Type | Organization |
Authorized Contact | DANETTE GRACE BAROWSKY Practice Administrator 910-592-5379 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC 200001330969) |
Enumeration Date | 2007-04-12 |
Last Update Date | 2009-10-01 |