| NPI | 1205795200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BENNETT HARRIS Physician Assistant 704-614-3795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-01-16 |
| Last Update Date | 2026-01-21 |