| NPI | 1831492628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN SHIPMAN Treating Ca 704-573-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 1509) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2011-02-22 |