| NPI | 1568674752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD LATZ Member Manager 704-662-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NC 35688) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |