| NPI | 1730382789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ROTHROCK Credentialing Coordinator 704-372-7974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2023-02-07 |