| NPI | 1386472538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KOSMEH Founder/CEO 910-465-2209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-25 |