| NPI | 1285080440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN LEAKE Office Manager 252-514-6594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 005002624) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-05-06 |