| NPI | 1437649381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL J RUTLEDGE Owner 704-264-5626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL MA59841) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |