| NPI | 1689260291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT K MATLACK Owner, Physician 910-323-1545 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2020-12-17 |