| NPI | 1851341937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT O SHELTON Billing 919-544-6318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 32555) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2008-08-20 |