| NPI | 1508027046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E KELL Primary Doctor 910-353-1499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NC 9600132) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2022-11-17 |