| NPI | 1265646053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID H ELLIOTT Owner 252-943-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 7976) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |