| NPI | 1194877357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JO STARK Office Administrator 828-697-1581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 101236) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |