| 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 | 2020-10-06 |