| NPI | 1497205272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ANN ODOM President Shared Services 947-522-3326 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2021-10-07 |