| NPI | 1750694170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI LYNN KAUFMAN Clinical Nutritionist 910-762-9701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: NC L000491) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2010-07-15 |