NPI | 1326579640 |
---|---|
Entity Type | Organization |
Authorized Contact | TREMIKA RENE WOODLEY Np 980-337-0353 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 5009223) |
Enumeration Date | 2017-03-27 |
Last Update Date | 2017-03-28 |