| NPI | 1750892659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN O'BRIEN Administrator Asc 336-564-4938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2020-01-02 |