| NPI | 1740762160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA ROBINSON CEO 336-409-9709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| 208D00000X General Practice | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QP2300X Clinic/Center Primary Care | |
| 291U00000X Clinical Medical Laboratory | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2018-09-01 |