| NPI | 1518141407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIE MANTIN Owner/ Only Provider 336-712-8225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200000535) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2013-07-11 |