| NPI | 1669727038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HUCKINS President Of Clinical Partnerships 704-678-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CO 488888) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |