| NPI | 1649304239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH LEE WILLEFORD Owner 910-755-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NC 36621) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2013-08-07 |