| NPI | 1215252119 |
|---|---|
| Former Legal Business Name | LAKE JEANETTE URGENT CARE, PLLC |
| Entity Type | Organization |
| Authorized Contact | SHELIA ANN WINFREY Billing Manager 336-286-5505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2018-01-25 |