| NPI | 1710956529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK L. PRENDERGAST Physician Director 704-873-5224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NC AS0042) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2010-02-18 |