| NPI | 1306039029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE M. LINETT Owner 910-791-2788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine Sports Medicine (Licence: NC 29322) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2014-10-07 |