| NPI | 1679027833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY KEARNEY Practice Administrator 704-872-0234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 9300179) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |