| NPI | 1700359403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALIKAH Y HODO Revenue Cycle Manager 704-259-4621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0800X |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2024-03-14 |