| NPI | 1740317197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS MICHAEL MAHAN Clinic Director 910-326-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 66693) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |