| NPI | 1215485024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DOLGE Executive Director 336-904-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2018-12-12 |