| NPI | 1316301146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E FASSLER Medical Director 704-909-9414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: SC SC19767) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2016-04-07 |