| NPI | 1427282045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES T. JOHNSON CFO 910-671-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NC H0064) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: NC H0064) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2020-10-08 |