| NPI | 1184749574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE BRIAN OUTEN Physician 704-624-3790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 9900973) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2009-06-24 |