| NPI | 1619124401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HICKS Chief Executive Offi 704-377-4009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2025-05-29 |