| NPI | 1205907573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLYNN KEELS DICKSON Physician 704-366-0249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 19158) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-08-22 |