| NPI | 1164215570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE DUNSTON Administrator, VP 336-716-3335 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-05-28 |