| NPI | 1396896684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA RICHARDSON VP Managed Health 704-631-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: IL 7001779) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2024-12-02 |