| NPI | 1851797336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS E WILLIAMS Sole Owner 910-763-8134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 9801110) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NC 9801110) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2014-11-12 |