| NPI | 1780652107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY HENSON Rcd 336-944-6420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| 225X00000X Occupational Therapist | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 207P00000X Emergency Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2026-01-22 |