| NPI | 1588274963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY ERICKSON Authorized Official 910-763-3601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2023-09-07 |