| NPI | 1346695319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E FASSLER Medical Director 704-909-9414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 068728) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |