| NPI | 1215377387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA D. POWELL Owner 704-822-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NC 190034) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2013-07-03 |