| NPI | 1306479837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEAN Executive Director 704-841-0240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-04-02 |