| NPI | 1417997842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY EDWARD GANDY President 251-580-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AL 6662) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-08-22 |