| NPI | 1437920030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH G BAILEY Chief Operating Officer 910-517-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-06-14 |