| NPI | 1598707713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT JOSEPH BLASE Owner 336-625-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 23878) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-10-08 |