| NPI | 1790024974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RISSMILLER Enterprise EVP 704-355-8675 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Additional Taxonomies | 207RS0010X Internal Medicine Sports Medicine |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2023-03-09 |