| NPI | 1205284205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH STONE Owner 984-999-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 2014-02319) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |