| NPI | 1356404453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. JANSEN Administrator 910-485-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 116914) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |