| NPI | 1720452584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RUSSELL FREEMAN Partner 251-544-6410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1152005) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2019-03-01 |