| NPI | 1174625248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL NORRIS GRANT Office Manager 336-282-0132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 200500050) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2025-10-16 |