NPI | 1326492364 |
---|---|
Entity Type | Organization |
Authorized Contact | HARRISON G FRANK Sole Mbr 910-679-8534 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-01636) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2011-01636) |
Enumeration Date | 2016-04-15 |
Last Update Date | 2017-08-29 |