| NPI | 1770768665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MARK WINEGARDNER Administrator 704-987-7970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9801807) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-08-05 |