| NPI | 1700323557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C LEE QUINN President 252-758-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 31627) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103099) |
| 363A00000X Physician Assistant (Licence: NC 100083) | |
| 363LF0000X Nurse Practitioner Family (Licence: NC 200996) | |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |