| NPI | 1538452982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI COX Secretary/Treasurer 704-525-6288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 9900407) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 222692) |
| 111NR0400X | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2017-05-09 |