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 |