| NPI | 1194990994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLIN LEE MOFFETT Owner/President 704-983-5763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: NC 139) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-28 |