| NPI | 1255399374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIA B CAGGIANO Busniess Manager 704-933-2266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC 117123) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-08-22 |