| NPI | 1295855054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YLONDA S HICKS Billing COO Rdinator 919-881-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 9400607) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |