| NPI | 1639346877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERRON SCOTT BRADY Owner 704-321-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 7411) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2021-09-09 |