| NPI | 1205983731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIROSE C. OLSON President 251-968-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 23373) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2009-04-02 |