| NPI | 1609918937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY G. MACKIE Office Manager 919-931-0490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC NC 102817) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |