| NPI | 1780919431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE S. BARKLEY Member 336-307-4096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NC 940094) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2009-10-14 |