| NPI | 1235886870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY A CLOWERS Owner 910-991-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 163W00000X Registered Nurse |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-05-11 |