| NPI | 1811177587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REVELLA B HARMON Medical Director 919-989-4051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 200000065) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2007-11-12 |