| NPI | 1699667394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARSON CLARK PATTERSON Registered Dietitian 336-713-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-07-17 |