| NPI | 1295579555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH GURLEY Owner 336-416-4093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2024-06-21 |