| NPI | 1699095331 |
|---|---|
| Doing Business As | SOUTHEAST CHILDREN'S UROLOGY |
| Entity Type | Organization |
| Authorized Contact | GEOFFREY GARDNER VP Of Finance 704-384-9094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2088P0231X |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |