| NPI | 1699608075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALIC PITTS Owner 704-677-1364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2026-06-05 |
| Last Update Date | 2026-06-05 |