| NPI | 1235309576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA VANLANDINGHAM Business Manager 251-296-1849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 6207) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |