| NPI | 1407047343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS MILLER SLAY Administrator 704-596-8401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC hal 060-038) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |