| NPI | 1427084755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ANTHONY NUTTALL GORDON Owner 910-272-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 9901642) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-08-22 |