| NPI | 1659722593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEVETTA RIVERS Administrator 336-254-1749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 200500152) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |