| NPI | 1215123393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TCHERNAVIA MONTGOMERY Chief Executive Officer 704-388-8110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2024-08-15 |