NPI | 1770735508 |
---|---|
Doing Business As | FAMILY MEDICINE AT REVOLUTION MILL |
Entity Type | Organization |
Authorized Contact | GEOFFREY K GARDNER VP Of Finance 704-384-9094 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2008-10-10 |
Last Update Date | 2010-03-29 |