| NPI | 1669852372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISHA RAE SMITH Practice Manager 252-728-5737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 30580) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-02-24 |