| NPI | 1447210976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COY RANDOLPH MATTHEWS President Of Corporation 910-642-2642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NC 36388) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2008-02-07 |