| NPI | 1740808096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT K MATLACK Owner, Medical Doctor 910-323-1543 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |