| NPI | 1700018843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN K LONG Owner 704-872-2350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NC 200500391) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |