| NPI | 1730903436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKITAS WILLIAM MILES Director Of Operations 704-727-6551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2024-11-11 |