| NPI | 1619188620 |
|---|---|
| Doing Business As | INDIAN TRAIL |
| Entity Type | Organization |
| Authorized Contact | THOMAS NANCE Administration 704-944-1135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |