| NPI | 1720138571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN L JACOBS Office Manager 910-521-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9901355) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2014-09-16 |