| NPI | 1326587361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN LEE SHELINE Founder, Director 336-543-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 29199) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |