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 |