| NPI | 1689372187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MOSS DIXON Executive Director 336-755-7045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2024-02-20 |