NPI | 1598918526 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTIN LUTHER BLUE Physician/Owner 704-235-6610 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NC 2005-1317) |
Enumeration Date | 2008-11-04 |
Last Update Date | 2009-06-04 |