| NPI | 1629129952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WALTER BRUCKERT President 919-851-7867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 0039359) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |