| NPI | 1760771406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE E LANTELME CEO 336-972-0784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 9601654) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2012-03-15 |