| NPI | 1386077790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C THOMAS JOHNSON Vice President/CFO 910-671-5090 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC HOS1599) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2013-08-21 |