| NPI | 1316349772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ALLEN Owner 919-820-2554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NC 9801445) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NC 253205) |
| 251S00000X (Licence: NC 9801445) | |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-10-24 |