| NPI | 1366671232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ANTHONY MANNING President / CEO 252-985-3009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2009-07-13 |