| NPI | 1588853865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WITTEN ALTIZER Physician/Owner 704-341-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: NC 9900407) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2013-10-28 |