| NPI | 1710183991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HADEN PAYNE BOLIEK Owner 910-483-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2013-08-15 |