| NPI | 1700751427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SHOREY Billing Manager 336-404-5722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2025-10-10 |
| Last Update Date | 2026-05-28 |