| NPI | 1548666878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BEAUCHAINE Physician Assistant 704-981-4490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 0010-05337) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |