| NPI | 1780701185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY MASSINO Account Tech Ii 252-728-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: NC 200222) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |