| NPI | 1578822326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PATE Office Administrator 919-988-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NC 32555) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |