| NPI | 1659364727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GROVER GODWIN Practice Administrator 910-738-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2010-07-20 |