| NPI | 1740712116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY SHUMATE Owner/ Manager 336-849-4171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 201391) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |