| NPI | 1740237767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYRUS J FAIRCLOTH CEO 910-295-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: NC 123151) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2010-02-26 |