| NPI | 1740534791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORA M ROMERO MIRANDA Owner 704-526-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 68283) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2013-01-17 |