| NPI | 1407551120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE MORTON Cmo, Owner 704-607-4835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-11-07 |