| NPI | 1861822793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY T MACKENZIE Owner/Physician 919-460-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: NC 9700320) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2013-11-13 |