| NPI | 1346636768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MOTLEY HATCHETT Owner 336-706-6614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 600053) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2022-10-05 |