| NPI | 1417344433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON REID BEAMAN Medical Director/Owner 252-308-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC 101911) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |