| NPI | 1477399038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEA JEANINE WALTON Managed Care Manager 704-316-6081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |