| NPI | 1679763759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE MAX LINETT Owner 910-791-2788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: NC 29322) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2014-01-02 |