NPI | 1336486620 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTEN HUDSON Partner 910-730-0840 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: NC 156187) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 2827) |
2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NC 156187) | |
Enumeration Date | 2013-01-07 |
Last Update Date | 2014-07-24 |