NPI | 1306957451 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLEY TOMPKINS Practice Administrator 910-332-3660 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NC 36297) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2024-09-26 |