| NPI | 1740324359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD DEAN WALTERS President 910-255-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 200101405) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |