| NPI | 1245399526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNESTINE SPELLER MELTON Owner 252-345-3663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC HC2300) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |