| NPI | 1295579555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH ANN GURLEY Physician Assistant 336-979-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2025-07-24 |