| NPI | 1760773949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD B. SHEALY Medical Director 336-768-3361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2012-03-14 |