| NPI | 1275848095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN KEITH WATERS Medical Director 251-633-0123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2023-07-24 |