| NPI | 1861733669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LEA GARD Practice Manager 336-349-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2014-01-30 |