| NPI | 1679130744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNES P DUPLESSIS Owner/Manager 910-536-5667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |