| NPI | 1790919637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CHAVIS President 704-283-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 3103) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2011-02-02 |