| NPI | 1669712063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MOORE Manager/Business Director 252-695-8049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |