| NPI | 1386605608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLIN GORDON KURTZ Authorized Official 252-955-0916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NC 39649) |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2022-10-20 |