| 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 |