| NPI | 1811889728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY FOSTER CEO 910-715-4473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2025-07-16 |
| Last Update Date | 2025-08-04 |