| NPI | 1689053613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA J LOWERY President 910-207-6597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2019-06-19 |