| NPI | 1538755376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY SELLICKA MERCER Owner 704-386-1723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QP3300X Clinic/Center, Pain | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 207K00000X Allergy & Immunology | |
| 207KA0200X Allergy & Immunology, Allergy | |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology | |
| 207RA0201X Internal Medicine, Allergy & Immunology | |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2022-04-12 |