| NPI | 1730565912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW T. BILLINGSLEY Medical Director 704-456-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 31108) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-11 |