| NPI | 1447622386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI L ROBERTSON Sole Director/President 919-908-6449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC 110748) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |