| NPI | 1720578313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BOX MORAN Owner 704-650-7156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 2008-00351) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2019-06-11 |