| NPI | 1801843925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN PICKETT Credentialing 704-926-5547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2023-10-11 |