| NPI | 1235383415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMAN S EDWARDS Owner 336-362-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 305R00000X) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2016-03-01 |