| NPI | 1659349041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE DENISE POWELL Member/Manager 336-765-3430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200001250) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2008-04-20 |