| NPI | 1760088900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SCHLICHER Fnp 704-964-6250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2023-05-09 |