| NPI | 1669697108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE B JACKSON Director 910-671-3404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| 261QP0905X Clinic/Center Public Health, State or Local | |
| 291U00000X Clinical Medical Laboratory (Licence: NC 34D0934973) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2024-07-25 |